ECMO stands for extracorporeal membrane oxygenation. In an ECMO machine, blood goes through a tube to an artificial lung that provides oxygen and removes carbon dioxide. Then the blood is warmed to body temperature and pumped back into your body when you are on the ECMO machine.
Types of ECMO
ECMO has two categories:
- VA ECMO: VA or Venoarterial ECMO. It is used when both the heart and the lungs of the patients are failing.
- VV ECMO: VV or Venovenous ECMO treatment is given to the patient when the problem is only in the lungs.
Who needs an ECMO Treatment?
Doctors use ECMO treatment in the following cases:
- When patients are recuperating from heart failure, lung failure, or cardiac surgery.
- When some high-risk procedure or surgery is being carried out.
- ECMO treatment is used as a bridge option in the following cases:
- When doctors examine the status of other vital organs such as the kidneys or the brain before performing any crucial surgery.
- ECMO works as a bridge to heart assist devices.
- For patients waiting for a lung transplant, ECMO keeps tissue oxygenated. It makes the patient a better transplant candidate.
ECMO Procedure
A surgery is required to place a patient on ECMO. Here is the procedure that is followed:
- The patient is sedated and given pain medicine and anticoagulants such as heparin, diuretics, electrolytes, and antibiotics.
- A surgeon inserts ECMO catheters into an artery/vein.
- An x-ray is taken to check that the tubes are correctly positioned.
- The patient is usually put on a ventilator, which aids in healing the lungs.
- Specially trained nurses and respiratory therapists, and the surgeon and surgical team keep an eye on the patient on ECMO.
- Supplemental nutrition is given through a nasal gastric tube or intravenously.
- The patient has a breathing tube in place.
- The tubes must be removed by surgery before ECMO is stopped.
- Several tests are routinely performed before ECMO treatment to ensure that your heart and lungs are safe and ready.
- The vessels will need repairing once the ECMO cannulas are withdrawn.
- The doctor will close the wound where the tubes were inserted with tiny stitches.
- Even if you are no longer on ECMO, you may need to use a ventilator.
Conclusion:
When a patient’s heart and lungs cannot operate properly, extracorporeal membrane oxygenation (ECMO) is conducted. It is a modified cardiopulmonary bypass circuit that acts as an artificial membrane lung and blood pump to facilitate gas exchange and systemic perfusion. In patients with acute respiratory distress syndrome, ECMO has been utilized as short-term rescue therapy.
Because bleeding is the most common ECMO consequence (30 to 40%), ECMO should only be conducted in locations with the necessary equipment and experience. ECMO is a complicated network that delivers oxygen and ventilation while allowing the lungs to rest and recover from respiratory failure with the least amount of ventilator-induced lung harm possible.
In patients with severe heart or respiratory failure, ECMO has been shown to enhance survival rates and reduce the frequency of complications in critical care settings.
