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Extracorporeal Membrane Oxygenation (ECMO)

What is ECMO?

ECMO MachineECMO stands for extracorporeal membrane oxygenation and is a treatment used for newborns and children who are critically ill with respiratory failure.  ECMO is a life-saving technique that mimics the function of the heart and lungs, allowing an infant or child to rest while healing of the organs naturally takes place.  ECMO is an artificial lung (membrane) located outside the body (extracorporeal) and is used to move oxygen into the blood, which carries it to body tissues (oxygenation).

Children's Memorial Hermann Hospital is one of only two hospitals in Houston offering pediatric extracorporeal membrane oxygenation (ECMO).  The Extracorporeal Life Support Organization (ELSO) has named the ECMO program at Children's Memorial Hermann Hospital a Designated Center of Excellence since the inception of the award. The ELSO award recognizes ECMO programs worldwide that distinguish themselves by having processes, procedures and systems in place that promote excellence and exceptional care in extracorporeal membrane oxygenation.


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When is ECMO used?

ECMO for Lungs:

Normally, the lung provides oxygen and removes carbon dioxide from the blood.  When thelungs are sick or injured, they are unable to do this even with maximum support from medication and machines.  ECMO can supply oxygen and remove carbon dioxide while allowing time for the lungs to heal.

For patients with severe lung conditions, mechanical ventilators could cause further damage and ECMO will be considered as an additional level of support.  The ECMO machine will act as the patient’s lungs to allow the necessary time to recover. Once the patient’s lungs have healed enough to allow the ventilator to provide adequate support again, the patient will be able to come off ECMO.

ECMO for Heart:

If the heart is unable to pump effectively, circulation of blood to the lungs may be affected, resulting in low oxygen levels.  Blood may not be pumped to the body adequately if the heart is damaged.  ECMO can be used to pump the blood to the lungs and throughout the body to support all other vital organs so the heart can rest and heal.

Depending on the heart condition, patients will be placed ECMO prior or post-surgery, to allow the body to receive adequate blood flow.is needed either before or after heart surgery, or in cases where a disease has weakened the heart muscles capability to pump blood through the body.  For patients that are in need of a heart transplant and ECMO can help “bridge” the patient until a heart is available. 

What are the different types of ECMO?

VA ECMO (veno-arterial) is used when the patient needs help with both heart and lung function.  The blood is drained from a large vein, runs through the ECMO circuit where it has oxygen added and carbon dioxide removed from the blood, before it returns to the body in a large artery.  This help to reduce the work that both the heart and lungs have to do, while still oxygenating the vital organs and tissues of the body.

VV ECMO (veno-venous) is used when the patient still has relatively good heart function, but the lung function is greatly decreased.  The blood is drained from a large vein, runs through the ECMO circuit where it has oxygen added and carbon dioxide removed from the blood, before is returns to the body in either the same or another large vein. 

Who is a candidate for ECMO?

  • Sepsis
  • Sudden cardiac arrest
  • Supportive treatment before or after cardiac surgery for congenital heart disease
  • Myocarditis
  • Asthma

Patient Story: Back from the Brink - Dominic Story

 

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