WHAT IS ECMO?
Extra-Corporeal Membrane Oxygenation (ECMO) is a life-saving advanced intensive care technology that is used when a child/adult has a condition which prevents the lungs or heart from working properly. It involves a machine that will take over the work of the heart and lungs (modified heart – lung machine in ICU) until they get better. It is used only when all other therapies fail or stop working.
ECMO CAN SUPPORT THE PATIENT FOR DAYS TO WEEKS.
The ECMO technology has a proven track record in a variety of conditions especially with respect to children and requires a dedicated team of medical and paramedical experts with round the clock bedside care.
The ECMO set up involves the vascular cannulae, the blood pump (controls blood flow), oxygenator (oxygenates blood and removes carbon dioxide), blood warmer and tubing’s through which the blood flows.
Veno Venous VV ECMO is used for only respiratory failure and Veno Arterial VA ECMO for cardiac failure.
Since it involves controlled systemic anticoagulation it should be used only in appropriate patients, at the appropriate time by well-trained persons.
WHO SHOULD BE CONSIDERED FOR ECMO?
- Acute Respiratory Distress Syndrome (ARDS) secondary to pneumonia, aspiration, severe air leak
- Refractory Septic / Cardiogenic Shock
- Myocarditis – viral, scorpion sting
- Post Arrest shock
- Before or after cardiac surgery
- Meconium Aspiration
- Congenital Diaphragmatic Hernia
- Persistent Pulmonary Hypertension
WHEN SHOULD ECMO BE CONSIDERED?
It should promptly be considered in patients with life threatening Respiratory or Cardiac Failure that does not respond to conventional intensive care management. Patients who benefit from ECMO have a reversible condition.