What is ECMO

Extracorporeal membrane oxygenation (ECMO) is a life support machine. People who need ECMO have a severe and life-threatening illness that stops their heart or lungs from working properly. For example, ECMO is used during life-threatening conditions such as severe lung damage from infection, or shock after a massive heart attack.

 The ECMO machine replaces the function of the heart and lungs. People who need support from an ECMO machine are cared for in a hospital’s intensive care unit (ICU). Typically, people are supported by an ECMO machine for only a few hours to days, but may require it for a few weeks, depending on how their condition progresses. There are many overlaps and differences between the use of ECMO in children and adults.
For a focus on Pediatric ECMO, please refer to the Medline Plus resource listed at the end, in addition to this document. Why is ECMO used? ECMO is used to help people whose:

• Lungs cannot provide enough oxygen to the body even when given extra oxygen
• Lungs cannot get rid of carbon dioxide even with help from a mechanical ventilator
• Heart cannot pump enough blood to the body ECMO may also be used to support people with heart or lung disease that cannot be cured while they wait for an organ transplant (e.g. new heart and/or lungs).

How does an ECMO machine work?
The ECMO machine is connected to a patient through plastic tubes (cannula). The tubes are placed in large veins and arteries in the legs, neck or chest. The procedure by which a healthcare provider places these tubes in a patient is called cannulation. The ECMO machine pumps blood from the patient’s body to an artificial lung (oxygenator) that adds oxygen to it and removes carbon dioxide. Thus, it replaces the function of the person’s own lungs. The ECMO machine then sends the blood back to the patient via a pump with the same force as the heart, replacing its function. The ECMO machine is controlled by a person called a perfusionist, or a nurse or respiratory therapist with advanced training called an ECMO specialist. The perfusionist or ECMO specialist will adjust the settings on the machine to give the patient the amount of heart and lung support they need.
How is a patient on an ECMO machine monitored?
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. Patients on ECMO need their blood tested very often to measure the oxygen and carbon dioxide levels.