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What are the risks? Any person who requires ECMO is very ill and will probably die without it. However, there are risks associated with this procedure. The ECMO physician will discuss these with you: - Bleeding - We give a drug called Heparin to prevent the blood from clotting while it travels through the ECMO circuit. We monitor how long it takes the blood to clot very carefully and make changes accordingly, but sometimes bleeding occurs. Bleeding can occur anywhere in the body but is most dangerous when it occurs around the brain. This could result in permanent brain damage. If the bleeding becomes too great, any of the following actions may be necessary:
- Frequent blood transfusions
- Other operations to control bleeding
- Discontinuing ECMO therapy
- Blood clots - Small blood clots may be introduced into the blood stream of the patient. These clots can cause serious injury to the patient, damaging vital organs such as the brain or kidneys.
- Stroke - Stroke may occur from bleeding, or blood clots into the brain. If your loved one needs cardiac support, a surgical procedure that involves permanently tying off one carotid artery (blood vessel) is sometimes performed. Although there are two carotid arteries that supply blood flow, brain injury, including stroke has occurred in some cases.
- Malfunction of ECMO equipment - Although rare, the equipment required for the ECMO system may fail. A trained ECMO specialist, at the bedside 24 hours a day, will respond quickly to any malfunction.
- Other - Surgeons perform an operation to attach the ECMO circuit to the patient. This may lead to infection, bleeding, or vocal cord injury. The function of the heart or lungs may not improve during the time of ECMO support. We may find that the patient has a disease that will not get better, even with ECMO. Some patients develop severe blood stream infections that cause irreversible damage to vital organs.
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