What is ECMO?

Extracorporeal Membrane Oxygenation (ECMO) is an advanced form of life support used when the heart, lungs, or both are unable to function properly. The ECMO machine takes over the work of these organs by pumping blood outside the body, removing carbon dioxide, and adding oxygen before returning the blood to the body. This gives the heart and lungs time to rest and heal while the underlying cause is being treated.

Types of ECMO

Veno-Arterial ECMO (VA ECMO)

• Supports both the heart and the lungs
• Used in patients with severe heart failure or cardiac arrest
• Blood is drawn from a vein and returned to an artery after oxygenation

Veno-Venous ECMO (VV ECMO)

• Supports only the lungs
• Used in patients with severe lung failure when the heart is still working
• Blood is drawn from a vein and returned to a vein after oxygenation

When is ECMO Used?

• Severe lung injury or infection
• Acute Respiratory Distress Syndrome (ARDS)
• Pulmonary embolism (blood clot in the lungs)
• Heart attack or severe heart failure
• Cardiac arrest not responding to other treatments
• Severe trauma affecting the heart or lungs
• Newborns with breathing or heart problems
• Support before or after heart or lung transplant
• Bridge to recovery, transplant, or long-term support device

Procedure Overview

How ECMO Works

• Thin tubes (cannulas) are placed into large blood vessels in the neck, chest, or groin
• Blood is drawn out of the body through these tubes
• The blood passes through a membrane oxygenator that removes carbon dioxide and adds oxygen
• The oxygen-rich blood is warmed and returned to the body
• The ECMO machine continues this process around the clock until the heart or lungs recover

Care During ECMO

• Patients are usually cared for in the intensive care unit (ICU)
• Continuous monitoring of heart rate, blood pressure, oxygen levels, and ECMO function
• Blood-thinning medicines are given to prevent clots in the circuit
• Sedation and pain medicines may be given based on the patient's condition
• A multidisciplinary team manages the patient at all times

Duration of Support

The length of time on ECMO varies based on the patient's condition. It may range from a few days to several weeks. Prolonged ECMO use can increase the risk of complications.

Risks and Complications

• Bleeding due to blood-thinning medicines
• Blood clots within the ECMO circuit or body
• Infection at the cannula insertion sites
• Stroke or brain injury
• Low oxygen delivery to certain parts of the body
• Mechanical failure of the ECMO equipment
• Damage to blood vessels where the tubes are placed

Long-Term Effects

• Kidney problems that may require dialysis
• Reduced blood flow to the legs in some patients
• Need for rehabilitation after recovery
• Possible long-term effects of the underlying illness

Benefits of ECMO

• Provides life-saving support when other treatments fail
• Allows the heart and lungs time to rest and heal
• Serves as a bridge to recovery, transplant, or long-term mechanical support
• Can be used in patients of all age groups, from newborns to adults
• Improves survival in selected critically ill patients

Recovery and Follow-up

After ECMO

• Patients are gradually weaned off ECMO once the heart or lungs recover
• The tubes (cannulas) are carefully removed
• Continued ICU care and monitoring is needed after ECMO is stopped
• Some patients may need additional treatments or surgeries depending on the underlying condition

Rehabilitation

• Physiotherapy to regain strength and mobility
• Respiratory therapy to improve lung function
• Nutritional support to help recovery
• Emotional and psychological support for the patient and family

Long-Term Follow-up

Regular follow-up visits are important after ECMO to monitor recovery, check for any long-term effects, and ensure continued treatment of the underlying condition.

Myths vs Facts

Frequently Asked Questions