A person who is experiencing problems with their heart and lungs may benefit from extracorporeal membrane oxygenation (ECMO), a form of artificial life support. Your blood is continuously pumped out of your body and sent through a succession of machines that remove carbon dioxide and provide oxygen. The machine then pumps your blood back into your body. When dealing with a respiratory illness, heart attack, or trauma, ECMO care can be quite helpful in allowing your heart and lungs to recuperate. A device that oxygenates blood outside the body is used in this life-saving procedure to temporarily bypass the heart and lungs.
ECMO is typically utilized in critical care settings for patients suffering from conditions such as severe cardiogenic shock, pneumonia, or during and after complex cardiac surgeries. Through the replacement of oxygen in the blood and the removal of carbon dioxide, ECMO stabilizes patients who may not react to traditional therapy, providing them with a critical window for recovery. Dr. Ravinder Singh is a leading expert in the field of Extracorporeal Membrane Oxygenation (ECMO), dedicated to advancing the understanding and application of this life-saving technology. He guides patients and medical professionals through the intricacies of ECMO, highlighting its importance in treating severe heart failure, using his vast experience in critical care medicine.
Dr. Ravinder Singh offers priceless insights into the complex ECMO process, the reasoning for selecting patients, and the critical post-operative care required for positive results. His commitment to education and research in ECMO not only enhances clinical practices but also improves patient survival rates.
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How Does ECMO Work?
Blood is removed from your body through a tube in a big blood vessel located in your neck, at your groin, or in your chest during an ECMO treatment. Your blood is pumped through tubes to a machine that eliminates carbon dioxide and adds oxygen. Then the machine pumps your blood back into your body. In addition to helping those who require lung support, ECMO therapy has the ability to bypass the heart and lungs.
Is ECMO Considered Life Support?
Yes. only patients in need of urgent or critical care are placed on ECMO, a sophisticated system used by medical professionals. Although they are a form of life support, mechanical ventilation systems are limited to moving air. They are unable to immediately take carbon dioxide and oxygen out of your blood. These gases can be exchanged by ECMO in a manner similar to that of your lungs.
What Conditions Does an ECMO Machine Treat?
Providers use ECMO for the following conditions:
1. Acute Respiratory Distress Syndrome (ARDS)
Acute respiratory distress syndrome, which limits the amount of oxygen your lungs can take in and expel from your blood, can be brought on by lung damage. This can happen with:
- Respiratory illnesses such as the flu, pneumonia, and the new coronavirus that causes COVID-19, among others.
- Sepsis, which damages your lungs.
- Burns and damage from inhaling. Your lungs can be harmed by breathing in hot air from a fire, smoke, or hazardous chemicals and fumes.
- Drug overdose.
- Pancreatitis. Your body may emit poisons and chemicals when your pancreas is inflamed, which could harm your lungs.
- Swallowing something through your mouth, such as food, drink, vomit, or water.
- Airway bleeding.
2. Pulmonary Embolism
A pulmonary embolism occurs when a blood clot that originated in your body—usually your legs—moves toward and becomes lodged in your lungs. This may prevent blood from entering your lungs, which may result in fatal heart and lung failure.
3. Heart Injuries
If you suffer from diseases or ailments other than trauma-related cardiac damage, you can require ECMO treatment. Some of these include:
- Heart attack.
- Your heart muscle may get bruised and damaged as a result of trauma, such as a fall or auto accident.
4. Infants and Newborns
ECMO treatment is frequently administered to newborns and infants, particularly those born prematurely, and who have heart or lung issues.
5. Transplants and Surgeries
ECMO can act as a “bridge” until a patient is able to receive the necessary treatment or operation. When a patient is awaiting a heart or lung transplant, or during certain circumstances, medical professionals employ ECMO:
- Heart and lung surgery.
- Transplant surgery.
- Recovery after surgery.
- Maintaining the longest possible life for an organ donor.
Advantages of Being on an ECMO Machine
For those who are really sick, an ECMO system can save their lives by supporting their heart and lungs. This can have the following effects:
- Reduces the pressure on the lungs and heart, allowing these organs to recover.
- Maintains a patient’s life during surgery or other medical operations.
- Supports a person as they wait for a transplant.
- Helps babies who were born with undeveloped lungs or heart problems.
What are the Possible Risks or Complications of Being on an ECMO Machine
Even though an ECMO machine is a very useful medical device, there are some serious hazards associated with it.
- Clotting Problems: The likelihood of blood clots forming requires blood thinners for anyone on ECMO. Clots could also become stuck in the ECMO circuit, interrupting blood flow.
- Infection: An infection can enter your bloodstream directly through any skin break, and the tubes of an ECMO circuit can harbor an infection. An infection may spread more easily as a result throughout your body.
- Bleeding: The need for tubes to enter large veins and arteries can make you more vulnerable to bleeding.
- Low or uneven blood oxygen levels: Your blood oxygen level should normally range from 95% to 100%. The target range for ECMO is typically 86% to 92%.
- ECMO circuit failure: The ECMO circuit as a whole may shut down in the event of a mechanical breakdown in any one component. This might harm your life.
- Stroke: Strokes can happen from blood clots in the circuit that end up going to the brain or from spontaneous bleeding in the brain while receiving ECMO treatment. This can be life-threatening.
When Should an ECMO Machine Not be Used?
Older adults are less likely to benefit from ECMO. Regarding age-related benefits and hazards, your healthcare professional can offer you advice. ECMO isn’t a possibility under several kinds of scenarios or situations. These include:
- When the patient has irreversible circulation, lung, or heart issues that cannot be resolved by transplantation.
- Individuals whose brains or livers or other vital organs are damaged.
- Cancer that has spread from its origin.
- Uncontrollably bleeding internally, particularly in the brain, or trauma that may cause bleeding to become uncontrollably excessive.
FAQs
What is ECMO?
A life-supporting procedure called extracorporeal membrane oxygenation (ECMO) temporarily replaces the heart and lungs. The blood is oxygenated, and carbon dioxide is expelled from the body, allowing the organs to recuperate.
Who can benefit from ECMO?
Patients with severe respiratory or cardiac failure, such as those suffering from cardiogenic shock, severe pneumonia, or during and following complicated heart surgery, are usually placed on ECMO. It may be considered when conventional treatments are sufficient.
How does the ECMO procedure work?
A machine draws blood from the patient’s body and passes it through a membrane oxygenator, which absorbs oxygen and releases carbon dioxide, as part of ECMO. The patient’s vital functions are then supported when the oxygenated blood is reintroduced into the body.
What are the different types of ECMO?
Venovenous (VV) ECMO, which primarily supports lung function, and Venoarterial (VA) ECMO, which supports both heart and lung function, are the two main forms of ECMO. The choice depends on the patient’s specific condition.
What are the risks and complications associated with ECMO?
Even while ECMO has the potential to save lives, there are hazards including blood clots, infection, and bleeding. Close monitoring and care are essential to minimize these complications.
