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Extracorporeal Membrane Oxygenation


Why is this procedure done?


Extracorporeal membrane oxygenation may be called ECMO. It is a very serious form of life support and is most often only used for days or a few weeks. It gives heart-lung bypass support outside of the body. This means it puts oxygen into the blood. It also gets rid of carbon dioxide out of the blood. This is done with an artificial lung. One more part of the ECMO machine pumps the blood back to the body, like the heart. ‚  
The EMCO machine works with the patients blood. The doctor places 1 or 2 tubes called a catheter into large blood vessels. Then, the blood can flow freely to the machine and be pumped back to the patient. The doctor may decide to do VA ECMO. This is used when both the heart and lungs have problems. The doctor will place a catheter into a vein and an artery. If only the lungs have problems, the doctor may decide to do VV ECMO. Then, the doctor will only place one catheter into a vein. ‚  
The doctor may order ECMO for very serious conditions like: ‚  
  • Congenital diaphragmatic hernia
  • Heart defects
  • Meconium aspiration syndrome
  • Pneumonia
  • Very bad air leak problems
  • Very bad pulmonary hypertension
  • Very bad infections

What will the results be?


It will give the body enough oxygen. The lungs and heart will have time to rest and heal. ‚  

What happens before the procedure?


  • ECMO is most often done in an emergency, when the patient is very sick. The doctor may place the patient on ECMO at the end of a surgery.
  • Your doctor will review the patients record and all the drugs the patient is taking. The doctor will perform an exam. Other tests may be ordered to make sure the patient is stable enough for ECMO. They include:
    • Head ultrasound
    • Chest x-ray
    • Arterial blood gases (ABG)
    • Electrocardiogram (ECG)

What happens during the procedure?


  • The patient will already have a breathing tube in place and many I.V.s. The doctor will order extra drugs to keep the patient pain free and lying still.
  • The doctor will decide what area to use for the procedure. This is based on the kind of ECMO the doctor will use and if the patient had heart surgery. It may be the area around the upper thigh, chest, or neck. The doctor will clean the puncture area with an antiseptic.
  • The doctor will make a small cut over the blood vessel.
  • The doctor will put a tube through the cut and into the blood vessel. The doctor may need to put in a second tube.
  • The ECMO machine is filled with blood from a donor and other fluids. The tubes are carefully stitched and taped in place. They are covered with a bandage. The doctor will attach the tubes to the ECMO machine.
  • The doctor will take an x-ray picture to see if the tubes are in the right place. The breathing tube will not be taken out. The doctor may turn down the settings so the lungs do not have to work so much.

What happens after the procedure?


  • The patient will stay in the hospital and be kept very sleepy.
  • There will always be extra staff members nearby to run the ECMO machine. They will watch the patient very closely and take lab tests very often.
  • The patient will need to be on a blood thinner while on ECMO. This will help keep the blood from clotting.
  • The patient will need to have blood transfusions while on ECMO.
  • As the patients condition gets better, the ECMO machine is turned down and eventually stopped. Then, the doctor takes the catheters out of the blood vessels. Often, the patient is still very sick.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Prevent clotting of blood in the tubing
  • Prevent infection and agitation
  • Help with pain and agitation
  • Promote urination
  • Replace blood loss and fluids

What problems could happen?


  • Bleeding
  • Blood clot
  • Infection
  • Problems with transfusion
  • Tube breaks
  • Pump stops
  • Lung and heart do not get better

Where can I learn more?


National Institute for Clinical Excellence ‚  
http://www.nice.org.uk/nicemedia/pdf/ip/IPG039publicinfoenglish.pdf ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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