Extracorporeal membrane oxygenation

An ECMO machine works for your heart and lungs, similar to a heart/lung machine used in open-heart surgery. When placed on ECMO, blood will flow through tubing placed in your chest, where you will receive oxygen from the machine’s lung. By using an ECMO machine in conjunction with a ventilator, it is easier to remove fluids from your lungs and make small breaths to keep them working and healing. This will continue until the heart and lungs are able to work on their own.

There are two types of ECMO, and they refer to the corresponding blood vessels used in the treatment. The two types include:

• Venoarterial (VA) ECMO — In this type of ECMO, a tube is placed in both a vein and an artery to help the heart and lungs rest and improve when there are problems with both.
• Venvenous (VV) ECMO — With VV ECMO, one or more tubes are placed in a vein. VV is used when there are lung problems only. In some cases, you could start on VV and need to be switched to VA.

Based on the status of your current condition, your doctor will need to confer with you and weigh certain risk factors before proceeding. These risks include:

• Bleeding
• Infection
• Small clots or air bubbles
• Transfusions

While we wish ECMO therapy was completely safe for everyone, unfortunately, complications, some life-threatening, can occur. However, our ECMO staff has received comprehensive training to prepare for any unexpected side effects that may arise, and you are in the best possible hands with our specialists by your side. Don’t be afraid to ask questions before or during ECMO.

Before ECMO starts, your doctor will order a series of lab tests to examine a variety of factors that affect your condition. These tests may also be done during ECMO, and they include:

• Arterial blood gas (ABG) — These tests are administered to check the oxygen and carbon dioxide levels in your blood.
• Chest X-ray — This is used looks at the lungs and to confirm the proper placement of the ECMO tubes in your chest.
• Computerized tomography (CT) scan — These scans are taken of your head so that we may see the status and capability of your brain.
• Echocardiogram — This test uses live ultrasound technology to examine your heart and how well it is functioning.

Coming off ECMO is done when the heart and lungs are showing consistent signs of improvement. By weaning off of ECMO, rather than coming off all at once, we can know if your heart and lungs are able to work and put oxygen in the blood. During the weaning process, the speed of blood flow through the ECMO pump is decreased, and aid from the ventilator is increased until we have full confidence that you are breathing properly. The amount of time it takes to come off the breathing machine varies.

Nutrition

While on ECMO, you will receive all nutrition needed for energy and healing through an IV or will be fed through a tube placed in the nose or mouth that goes to the stomach.

Visitation

Family plays an important part in recovery. While on ECMO, there are some things your family can do to help:

• Bring music or relaxation tapes
• Bring photographs
• Call to check in at any time, day or night
• Come visit and interact as normal
• Have any small children color or draw pictures at bedside