Abstract: Refractory septic shock in children can quickly progress to multiple organ failure with high mortality rate. Extracorporeal membrane oxygenation （ECMO），as a rescue method for refractory septic shock highlighted as circulatory collapse after the failure of fluid resuscitation and inotrope therapy，is receiving more and more attention . However，the exact efficacy，timing，modality and routes of catheterization of ECMO in refractory septic shock are still unclear. In this paper，the history，application principle，points at issue and concerns during the operation of ECMO in the treatment of these children are discussed for more reasonable and standardized application of ECMO technology in children with refractory septic shock in order to improve their survival rate.

Key words: extracorporeal membrane oxygenation, septic shock, child

摘要： 儿童难治性脓毒症休克可很快进展为多器官功能衰竭，病死率高。体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）技术作为液体复苏无效和血管活性药物抵抗的难治性脓毒症休克的挽救性治疗正越来越受到重视和应用。但目前对于难治性脓毒症休克时ECMO救治的确切疗效、应用时机以及模式、置管方式等方面仍不明确。该文就ECMO治疗此类患儿的应用原理、发展历史、争议焦点和ECMO运行期间应关注问题进行探讨，以期更为合理、规范地应用ECMO技术治疗难治性脓毒症休克患儿，提高生存率。

关键词: 体外膜肺氧合, 脓毒症休克, 儿童