ECMO provides an extra level support for heart or lung failure
Extra corporeal membrane oxygenation (ECMO) uses advanced technology to provide temporary blood circulation and respiratory support in cases of life-threatening heart or lung failure, while these organs recover from injury, illness or a surgical procedure. ECMO can also can be used as a life-supporting, short-term bridge to a heart transplant or lung transplant.
ECMO technology both provides needed oxygen to the blood (lung/respiratory support) and helps circulate it throughout the body (heart/circulatory support).
The machine replaces the function of the heart and lungs from a few hours up to multiple days, depending on the condition and progress.
Baylor Scott & White Health is the largest ECMO provider and the largest ECMO transfer program in the state of Texas.
Conditions treated by ECMO
Extra corporeal membrane oxygenation may be appropriate for patients experiencing heart and/or lung failure due to a variety of causes.
Respiratory (lung) failure due to:
- Acute respiratory distress syndrome (ARDS)
- Pneumonia
- Flu (influenza)
- Ruptured lung (massive bronchopleural fistula)
- Post-trauma shock lung
- End-stage lung disease (cystic fibrosis, pulmonary fibrosis)
Heart failure due to:
- Heart attack (acute myocardial infarction)
- Decompensated chronic heart failure
- Myocarditis
- Cardiomyopathy
- Cardiopulmonary resuscitation adjunct (E-CPR)
What to expect
The ECMO machine is connected to a patient’s body through plastic tubes placed in large veins and arteries in the body. The machine pumps blood from the patient’s body to an artificial lung (oxygenator), which adds oxygen to it and removes carbon dioxide. This replaces the function of the patient’s own lungs.
When a patient is first being connected to an ECMO machine, he or she is sedated and does not feel the tubes going into the veins and arteries. Once connected to an ECMO machine, the cannula are not painful. Patients who are on an ECMO machine may be given medicines (sedatives or pain controllers) to keep them comfortable.
Monitoring
Any patient connected to an ECMO machine in the ICU is also connected to monitors. These monitors measure heart rate, blood, pressure and oxygen levels.
Members of the patient’s healthcare team use all of these results to see how well the ECMO machine is helping the patient and to make changes if needed.
Risks of being on ECMO
There are complications that may occur from being on the ECMO machine.
Some of the problems include but are not limited to:
- Bleeding
- Kidney failure
- Infection
- Leg damage
- Stroke
Duration
An ECMO machine simply provides support for a patient while the healthcare team works on treating the underlining disease or injury (such as an infection) or until organs for transplant are available. Some diseases or injuries can be treated quickly, and patients only need the ECMO machine for a few hours. Others need the ECMO machine for several days to weeks.
When the disease or injury improves, the healthcare provider will begin to reduce the amount of support the ECMO machine is providing to see if the patient will be OK. If the patient remains stable during this period, the surgeon will remove the device in the operating room or the ICU and stitch the entry spots to close the sites.
Extra corporeal membrane oxygenation does not cure or treat the disease that led to heart and lung failure. This means it is only a treatment that can prolong the patient’s life during the treatment process. Sometimes patients do not improve while on ECMO and the healthcare provider will assist you and your family with discussions about end-of-life support.
Specialized centers
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