Why ECMO?
We use ECMO on children and adult patients with severe, but reversible heart or lung disorders that have not responded to the usual treatments of mechanical ventilation (ventilator), medicines, and extra oxygen.
Patients who need ECMO usually have one of the following problems:
- Severe pulmonary hypertension – high blood pressure in the lungs
- Pneumonia
- Breathing failure from trauma or severe infections
- Heart failure
ECMO will not cure these conditions; it does give support and allow time for the lungs/heart to heal. We believe this recovery time improves the chances for the survival of your loved one.
When a patient is transferred here for ECMO, our physicians will carefully monitor their needs. Not all patients sent here for ECMO need this treatment. Some will get better because we have other therapies that the referring hospital does not have. Some will have medical problems that ECMO cannot help. We want to make sure the patient does not have any problems that ECMO could make worse or not help at all.
Babies will usually have a cranial ultrasound study and a cardiac ultrasound study before we place them on ECMO. The cranial ultrasound uses sound waves and lets us look at the brain to make sure there has been no bleeding around the brain. We will also do this test after the patient is on ECMO. The cardiac ultrasound study lets us look at the heart to make sure it is normal. The cardiac ultrasound also helps us to decide which type of ECMO to use (VA or VV). Children and adults will not have a cranial ultrasound, but may have a cardiac ultrasound. We may obtain other lab work and evaluations. A member of the ECMO Team will explain the tests and what they mean. Depending on these test results and if it is determined that the patient could benefit from ECMO, the following will take place:
- The patient is transferred to the Pediatric Intensive Care Unit
- The patient gets medicine to control pain.
- The patient gets medicine that will temporarily restrict movement.
- We insert one cannula (for VV) or two cannulas (for VA or VV). We place one cannula in the jugular vein; the tip sits in the right atrium of the heart. We place the other, if needed, in the carotid artery and sits in the aorta or in a vein in the groin.
- The surgeon connects the cannulas to the ECMO circuit. We fill the circuit with blood while the surgeon inserts the cannula. The patient is now on ECMO.