Extracorporeal Membrane Oxygenation (ECMO)
A technological advancement known as extracorporeal membrane oxygenation (ECMO) is one of the many options available at Batson Children's Hospital to help save young patients threatened by heart or lung failure. It provides “temporary life support" before and after cardiac surgery or while the heart and lungs heal.
ECMO is similar to heart-lung bypass machines used during open-heart surgery. However, while traditional bypass is used only during the surgery, ECMO is often used for days or weeks. In the past, children stable enough for transport who required this therapy were flown to out-of-state hospitals. Now they can receive treatment closer to home, allowing families to visit more often.
The mechanical therapy provides organ support by acting as an artificial lung when a child's lungs are damaged or diseased. When the lungs are not working properly, even with support of a ventilator, ECMO can do the work while the lungs heal. Blood is circulated through a device, which adds oxygen and removes carbon dioxide, and then returned to the body.
Likewise, if the heart is severely defective or damaged and cannot pump blood to the lungs effectively, a child may suffer from low oxygen levels in the body. In those cases, ECMO pumps oxygenated blood, so the heart can rest and heal.
Cardiac ECMO may be necessary either before or after heart surgery, or in cases of disease or infection that severely weaken the heart's ability to pump blood.
Conditions for ECMO use
- Severe pneumonia
- Acute respiratory distress syndrome (ARDS)
- Meconium aspiration syndrome
- Persistent pulmonary hypertension
- Congenital diaphragmatic hernia
- Life-threatening asthma
- Septic shock
- Poor heart function
- Support before cardiac surgery
- Support after cardiac surgery
- Heart failure/cardiac arrest
ECMO does not occur without risks, and not all patients who have life-threatening cardiac or pulmonary failure are candidates. The cardiac and/or pulmonary failure must be an acute problem, since chronic failure would not be expected to heal quickly. This therapy is temporary, lasting a few days to a few weeks.
The ECMO physicians evaluate patients with regard to disease process and duration of time expected for the heart and/or lungs to heal. As a general guideline, criteria for ECMO include:
- Acute life-threatening cardiac and/or pulmonary failure.
- The probability of death due to the acute phase of this disease is high.
- The disease process is reversible and expected to resolve within a short period of time.
The Batson Children's Hospital program is a member of Extracorporeal Life Support Organization (ELSO), an international consortium of health care professionals and scientists dedicated to the development and evaluation of novel therapies for support of failing organ systems.