What Is ECMO?
ECMO is a form of life support if you have serious lung or heart failure, injuries, or the heart or lungs are too weak to work properly. Extracorporeal means "outside of the body." A membrane oxygenator puts oxygen in the blood and removes carbon dioxide.
ECMO is most often used when other treatment options do not improve the lung or heart condition but there is still a possibility of recovery.
There are two types of ECMO:
- Venovenous (VV) ECMO supports only the lungs
- Veno-arterial (VA) ECMO supports both the heart and lungs
When severely weakened, ECMO takes the place of the functioning of the lungs or heart to allow them to rest and heal. ECMO can be used on infants, children, and adults. Along with respiratory failure, lung conditions that may require the use of ECMO support include:
- Acute respiratory distress syndrome (ARDS)
- Pulmonary embolism
- Infectious respiratory viruses like COVID-19, flu or pneumonia
- Hantavirus Pulmonary Syndrome (HPS)
- Waiting for or recovering from a lung transplant
Infants may use ECMO for conditions like congenital diaphragmatic hernia and meconium aspiration. Among other heart conditions, ECMO may be used for complications from a heart transplant, heart attack, hypothermia, sepsis, and cardiac arrest.
What to Expect?
Being placed on ECMO requires a surgical procedure. During the surgery, doctors will place one or more cannulas or tubes in a blood vessel in your neck, groin or chest. One cannula continuously draws blood out from a large blood vessel and puts it through a pump which moves the blood through an external, artificial lung.
The artificial lung removes carbon dioxide (or waste gas) from the blood and then adds oxygen to the blood. A second cannula returns oxygenated blood into your body. If ECMO supports only your lungs, your heart pumps blood throughout the body. You may also be on a mechanical ventilator to help you breathe.
The ECMO team consists of highly trained medical professionals like doctors, nurses, perfusionists or ECMO specialists, and respiratory therapists who monitor your recovery and the machine. The healthcare team will use chest X-rays to see how well your lungs are healing, check your oxygen and carbon dioxide levels, and watch for signs of infection. The healthcare team will also monitor for signs of pain, give medication through an IV, and provide nutritional support through a feeding tube.
Understanding the Results?
ECMO does not cure your heart or lung condition. The length of time you will be on ECMO depends on the underlying heart or lung condition. You may be on ECMO for a few days or weeks. Once your condition shows signs of improvement, the healthcare team will begin to wean you off during a trial period.
If you continue to show improvement or your healthcare team feels you are not improving, then ECMO will be discontinued. A surgical procedure is needed to remove the tubing. You may need physical therapy after using ECMO to help you regain muscle strength.
What Are the Risks?
While ECMO is a life-saving procedure, there is potential for complications. Among others, potential risks include bleeding, blood clots, and infection. There is also a risk of stroke. You will be monitored for signs of an infection while you are on ECMO and given medication to prevent blood clots. As with any medical equipment, there may be a possibility ECMO could fail, however, the ECMO team is trained to respond and correct the problem.
Page last updated: October 11, 2024
