WHAT IS EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)?

Learn from Dr. Dhaval Naik, experienced ECMO Expert from Ahmedabad, with a record of successful 15+ ECMO Surgical activities.

ECMO stands for Extracorporeal Membrane Oxygenation. Extracorporeal means outside of the body. A membrane oxygenator is a piece of equipment which acts as a lung to deliver oxygen into the baby’s blood. The ECMO circuit acts as an artificial heart and lung for the patient while on ECMO. It may help support a child who is awaiting a lung or heart transplant.

ECMO is a life-saving technique that mimics the natural function of the heart and lungs, allowing a patient to rest while natural healing of the affected organs takes place. It is used for patients suffering respiratory and/or cardiac failure as a result of variety of heart/lung diseases.

Throughout extracorporeal membrane oxygenation, the patient is the center of a highly coordinated team medical effort and receives around-the-clock care while on this "heart lung machine". The ECMO procedure involves channelling the patient's blood into a roller pump that serves as the child's "heart" throughout treatment. The pump sends the blood through an oxygenator, which serves as an artificial lung, infusing the blood with oxygen and removing carbon dioxide and returning it to the patient.

TYPES OF ECMO

There are several forms of ECMO, the two most common of which being venoarterial (VA) and venovenous (VV). In both modalities, blood drained from the venous system is oxygenated outside of the body. In VA ECMO, this blood is returned to the arterial system and in VV ECMO the blood is returned to the venous system. In VV ECMO, no cardiac support is provided.

WHY IS ECMO USED?

ECMO is used in infants who are sick due to heart problems or breathing problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal.

A few other most common conditions are:

Birth Defects of Heart
Severe Pneumonia
Congenital Diaphragmatic Hernia (CDH)
Meconium Aspiration Syndrome (MAS)
It is also used during the recovery period after major heart surgery.

COMPLICATIONS OF ECMO

Because extracorporeal pulmonary support is a bridging procedure rather than a causal treatment, the underlying illness must be potentially treatable, and indication of the procedure must be targeted.

Additional risks include:

Bleeding
Blood clot formation
Infection
Transfusion problems

In adults, ECMO survival rates are around 60%.

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FAQs

Who needs ECMO?

Your child has a heart and/or lung condition that needs additional support can be achieved through an ECMO machine. ECMO stands to be successful when infants and children who do not respond to traditional therapy.

Who will be taking care of my child while on ECMO?

These include the critical care physicians, pediatric cardiac surgeons, ECMO specialists, perfusionists, respiratory therapists and physical therapist.

How will my child be placed on ECMO?

ECMO pump is attached to the baby through catheters (cannula) that are placed into large blood vessels in the baby's neck or groin.

What are the risks for my child on ECMO?

A child that requires ECMO can be critically ill. ECMO can be a life-saving treatment, however, it is also important that the parents understand the possible risks as given above.

Is ECMO painful?

Generally ECMO support is not painful. But the cannula sites and lack of mobility can cause certain uncomfortable feelings.

How will my child receive nutrition while on ECMO?

While on ECMO your child may be fed breast milk and/or formula through a tube that enters his/her nose or mouth and empties into the stomach. If your child does not absorb the food properly then he or she will be fed nutrition through IV fluids into his/her veins.

How long will my child be on ECMO?

It is difficult to predict the time needed for ECMO. It is generally continued until the heart and lung problem is improved or solved.

Extracorporeal Membrane Oxygenation (ECMO)