ECMO is a technology for supporting pulmonary and cardiac function in emergency patients

ECMO or extracorporeal membrane oxygenation machine or also known as extracorporeal life support (ECLS) is a cardiopulmonary bypass with a reduced design made to be usable outside the operating room, with a usage capacity spanning multiple weeks. On the other hand, heart-lung machines that are used during heart surgery are used for only a few hours at a time.

 

The responsibility of ECMO is to add oxygen to the blood supply and remove carbon dioxide (by working similarly to the human lungs). It also contributes to the circulatory system and helps maintain appropriate blood pressure levels (by working similarly to the human heart). ECMO was developed to work in place of the heart and lung machine for many days at a time until the heart and lungs respond better to treatment. Theoretically, it helps support treatment and increase the survival rate of patients who require emergency treatment.

 

1. Cardiac arrest due to acute myocardial infarction and unresponsive to advanced life-saving procedures.

2. Obstructive blood clots in the pulmonary arteries causing abnormal pulmonary function.

3. Heart failure along with respiratory system failure due to many causes such as ARDS, H1N1 or Covid-19.

4. Heart surgery patients whose heart and lungs are not yet able to resume normal function after heart surgery.

5. Patients who require an extended period of breathing assistance whose breathing machine is unlikely to be able to adequately assist in the body’s gas exchanges.

6. Patients waiting for heart replacement and lung replacement surgeries.

 

Although ECMO can support the function of the heart and lungs, if the patient has some co-presenting factors, it might be impossible for the patient to use ECMO, for example, end-stage cancer patients, patients who have been using a breathing machine for a long time or patients with aortic regurgitation/dissection, etc.

 

Furthermore, there can be some side effects from use of ECMO such as brain hemorrhaging, ischemia of the legs (in patients with a veno-arterial ECMO system), hemolysis, infection, thrombocytopenia, etc. Therefore, medical teams, nurses and multidisciplinary teams have to provide 24-hour close patient monitoring and care.