What happens on ECMO?
After the patient is on ECMO, we will turn the ventilator (breathing machine) settings
down to "rest" settings. This allows the lungs to rest without the damaging effects of too much oxygen or pressure from the ventilator. We may also turn down many of the heart medicines.
All ECMO patients have a daily routine; this includes a chest x-ray each morning, weight and bath, blood samples (labs) and constant monitoring of vital signs. We draw the blood samples off the ECMO circuit or IV’s. The patient will not be "poked" by a needle while they are on ECMO. We let the patients rest as much as possible while they are on ECMO.
Medications
We give pain medication on a regular basis to prevent any discomfort. We try to maintain the patient in an alert, awake state. However, this is not always possible. Some patients do require medicine to keep them asleep and to keep them from moving to decrease the amount of oxygen used by the muscles or to insure that they don’t move too much and dislodge the cannula.
- Heparin is a drug that keeps the blood from clotting normally. We give heparin when we place the cannulas and we will give it continuously while the patient is on ECMO. We do this to keep the blood in the circuit from clotting. The ECMO specialist monitors how long it takes the blood to clot very carefully and makes changes accordingly.
- We give antibiotics to treat existing infections or to prevent infections.
- Sometimes a patient's blood pressure or heart needs some help and the physician will order medications for this purpose. Some of the names you might hear are Dopamine, Dobutamine, Inocor, or Epinephrine.
We place ECMO patients on a special bed. It is elevated because gravity plays a part in the amount of blood that can safely travel through the ECMO system.
We suction the lungs regularly since the patient's cough mechanism is not effective. We provide nutrition through specially formulated solutions administered through the veins or through a tube inserted through the mouth or nose that goes into the stomach.