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Similar to the heart-lung bypass machine used in open heart surgery, extracorporeal membrane oxygenation (ECMO) is an advanced life-support device that pumps and oxygenates a patient’s blood outside the body, permitting the heart and lungs to rest. When connected to the ECMO machine, your blood flows through tubing to an artificial lung inside the machine that adds oxygen and removes carbon dioxide. The blood is then warmed to your body temperature and pumped back into your body.
ECMO machines have been around since 1970s, and are often associated with infants in respiratory distress. ECMO is not a routinely prescribed procedure. It’s only used when all other life-saving options have been exhausted.
There are two types of ECMO machines:
Small, ultra-light portable ECMO machines are available that can be carried by one person in the event of an emergency. These machines are light enough to be transported in an ambulance or helicopter and have the ability to save more lives in emergency situations.
ECMO is used in the following situations:
Both initiating and discontinuing ECMO requires a surgical procedure that can be done at the bedside in a patient’s room. You’ll be given sedation and an anticoagulant to help prevent your blood from clotting. A surgeon will insert the ECMO catheters into either veins or an artery with the help of other surgical team members. Tube placement will then be verified with an X-ray.
Most patients on ECMO are also on an artificial breathing machine called a ventilator. This machine helps your lungs heal properly. While on ECMO, specially trained nurses and respiratory therapists will monitor you frequently, along with your surgeon and surgical team. Because you’ll be sedated and on a ventilator, supplemental nutrition will be provided either intravenously or through a naso-gastric tube (a tube that’s inserted through the nose that goes down into the stomach). While on ECMO, you may receive any of the following medications:
As with any surgical procedure ECMO does involve certain risks including:
For more information about extracorporeal membrane oxygenation, talk to your heart or lung specialist.
UCSF Department of Surgery. Extracorporeal Membrane Oxygenation. Accessed February 2, 2018.