Extra Corporeal Membrane Oxygenation (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, and the machine replaces the function of the heart and lungs. People are supported from a few hours up to multiple days, depending on their condition and progress.

ECMO is used to help people whose:

• Lungs cannot provide enough oxygen
• Lungs cannot get rid of carbon dioxide even with help from a mechanical ventilator
• Heart cannot pump enough blood to the body

The ECMO machine is connected to a patient’s body through plastic tubes placed in large veins and arteries in the body. The ECMO 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. The ECMO machine returns the blood back to the patient via a pump with the same force as the heart, replacing its function.

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.

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 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.

The healthcare team looking after patients on ECMO aims to avoid any 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 and stroke.

The ECMO machine supports the patient while working to overcome a disease or injury. If 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.

ECMO 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.