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Extracorporeal Membrane Oxygenation (ECMO)

What is ECMO?

Extracorporeal membrane oxygenation (ECMO), also known at extracorporeal life support (ECLS), is an advanced life support treatment for critically ill patients with life-threatening heart and/or lung problems. A lifesaving technique that supports the function of the heart and lungs, ECMO allows an infant or child to rest while healing of the organs naturally takes place.

The Pediatric ECMO Program at Children’s Memorial Hermann Hospital (CMHH) has been recognized by the Extracorporeal Life Support Organization (ELSO) as a Designated Center of Excellence since the inception of the award in 2006, recognizing international ECMO programs for having processes, procedures and systems in place that promote excellence and exceptional care. Our Program began in 1992, one of the oldest in Texas, and has used ECMO to treat more than 500 patients. As a high-volume program in Texas, the Pediatric ECMO Program supports approximately 30 children each year.

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What does ECMO stand for?

ECMO stands for extracorporeal membrane oxygenation

  • Extracorporeal – located outside the body
  • Membrane – an artificial lung
  • Oxygenation – used to move oxygen into the blood

When is ECMO used?

ECMO for the lungs:

Normally, lungs provide oxygen and remove carbon dioxide from the blood. When the lungs 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, 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. A highly specialized treatment, ECMO can support patients for days to weeks while doctors treat their underlying illness.

ECMO for the 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 on ECMO before or after heart surgery, to allow the body to receive adequate blood flow. For patients that are in need of a heart transplant, ECMO can help “bridge” the patient until a heart is available.

What are the different types of ECMO?

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

Veno-Venous (VV) ECMO is used when the patient still has relatively good heart function, but the lung function is greatly decreased. This type of ECMO does the work of your child’s lungs. 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 is returned to the body. Your child’s heart continues to pump blood to the body.

Who is a candidate for ECMO?

ECMO may be considered for infants, children and adolescents with a variety of illness and injuries, including:

  • Aspiration pneumonia
  • Asthma
  • Congenital diaphragmatic hernia
  • Congenital heart disease – supportive treatment before or after cardiac surgery
  • Meconium aspiration syndrome (MAS)
  • Myocarditis
  • Near drowning
  • Pulmonary hypertension
  • Sepsis
  • Severe pneumonia
  • Sudden cardiac arrest
  • Patient Story: Back from the Brink - Dominic Story

     

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