There has been a continuous refinement during the recent years of cardiopulmonary bypass for cardiac surgery, cardio circulatory support as well. This enabled us to apply cardiopulmonary bypass beyond the classical applications in cardiac surgery. Innovative techniques of perfusion, apparative refinement and continuous development in analyzing and monitoring of cardiopulmonary bypass have shown that surgery for impressive intracranial aneurysms in neurosurgery and complex surgery of aortic arch under deep hypothermic cardio circulatory arrest can be safe. Extracorporeal pulmonary assist was the most frequently requested for acute lung failure. At the center of the continuous development of CPB are, on one side, the improved biocompatibility of surfaces with blood contact, and a global miniaturization of the heart-lung machine. Minimal extracorporeal circulatory systems (MECC systems) have now different interdisciplinary applications (Table 1). The major advantage of MECC systems in medicine is a versatile applicability. Without great modifications of machinery, they can be used for different operations and for circulatory support. Use of miniaturized extracorporeal systems today is an unavoidable tool in the modern discipline of perfusion. We report about the special applications of such systems in our clinic (Table 1). Application of MECC with different indications as used at the University Hospital Regensburg in the period of 1998 up to November 2006. A Life Support System (LSS), in the form of a miniaturized cardiopulmonary bypass circuit, is acutely applicable any time, e.g. for patients in cardiogenic shock, during or after an unsuccessful intervention in the cardiology catheter laboratory aiming for a stabilization in hemodynamics. Survival of patients after cardiac arrest, followed by a prolonged conventional resuscitation, is low. This fact enabled us to serve the resuscitating teams as soon as possible in order to stabilize sufficient blood circulation under extracorporeal circulation (LSS) via femoral vessel access.1,2 Miniaturized extracorporeal circulatory systems allow, during the rewarming process after drowning, a continuous correction of metabolic disorders. In addition, such a system possibly can continuously support pulmonary function by extracorporeal lung assistance to immediately normalize gas exchange and help cure pulmonary damage. This measure joins the traditional methods (ECMO, pECLA, ECCO2R) of supporting pulmonary function as a therapeutic option in cases of irresolvable respiratory failure. There has been an increasing appeal during the last decade of using such systems for transportation of respiratory insufficient or hemodynamically unstable patients to those hospitals which will provide maximal patient support. In our estimation, it makes more sense to transport equipment and specialized personal to peripheral hospitals instead of the transportation of critical ill patients. Such a service is offered by our Clinic for Cardiothoracic Surgery for the surrounding area by use of mobile extracorporeal support systems.