ECMO or Extracorporeal Membrane Oxygenation

ECMO, or extracorporeal membrane oxygenation, is often regarded as a form of artificial life support. It performs the function of both the heart and lungs when these organs are unable to work properly. On one hand, it pumps blood throughout the body. It then sends blood to the devices that add oxygen and remove carbon dioxide. This oxygenated blood is again pumped back into the body.

How it works During this procedure, there is an outward movement of the blood with the help of a tube inserted into a large blood vessel. The location can be near your groin, your neck, or in the chest. There is a pump that pushes blood through tubes to a machine. The machine then adds oxygen and removes carbon dioxide from the blood, which is then pushed back into your body.

Is ECMO - a life support? In medicine, ECMO is considered a life support therapy. The doctors use these machines for the patients who are admitted to the intensive care unit.

What is the difference between ECMO and ventilators? ECMO is a complex setup that can exchange gases just like our lungs. On the other hand, mechanical ventilation can just move air. They do not add oxygen or remove carbon dioxide from the blood.

Types of ECMO?

• VV ECMO to support lungs
• VA ECMO to support lungs + heart

In which conditions can a doctor recommend ECMO? Some of the conditions in which ECMO is recommended are:

Acute respiratory distress syndrome (ARDS): Sometimes, your lungs are unable to maintain oxygen and remove carbon dioxide from your blood due to conditions causing acute respiratory distress syndrome. Some of these conditions are:

• Respiratory infections such as pneumonia
• Sepsis
• Burns
• Inhaling hot air from a fire, smoke, toxic chemicals and fumes
• Inflammation of your pancreas (pancreatitis) can release toxins damaging your lungs
• Drowning
• Aspirating objects into your lungs (vomit, water, food or beverages) Foreign bodies
• Bleeding in the airway

Heart Injuries: Heart attack or other trauma (fall or car crash) cause damage to the heart muscle, thus warranting ECMO

Pulmonary embolism: Sometimes, a clot formed in other parts of the body travels all the way through the blood, reaches the lungs, and gets stuck there. This clot obstructs the blood flow through the lungs and causes heart and lung failure, which may be fatal.

Transplants and Major Surgeries: Doctors may use ECMO during the below-mentioned times: Patient waiting for an organ before transplant (heart or lung) Surgery involving heart or lung or both Post-surgical recovery

Drug Overdose: Insertion of medicines in quantities, which is reaction to heart.

What are the benefits of ECMO? ECMO has emerged as a lifesaver for patients with compromised heart and lungs Some of the benefits of ECMO are:

• Reduced stress on the heart and lungs, thus giving them sufficient time to heal
• Can keep a person alive during a complicated surgery or when waiting for an organ before heart and lung transplant
• Support infants with premature heart and lungs until they fully developed

What are the risks associated with ECMO? Some of the potential complications of ECMO are:

• Infection: ECMO tubes can act as a direct passage for infections into your bloodstream, which can be fatal
• Clotting Problems: ECMO can increase the risk of clot formation, which can get stuck in the machine. Therefore, blood thinners are recommended for patients on ECMO.
• Circuit failure: ECMO, like any other machine, is prone to failure, which can be life-threatening
• Bleeding: Tubes in the major arteries can increase the risk of bleeding
• Low or irregular oxygen levels in the blood: Sometimes, oxygen levels in the blood fluctuate because of ECMO
• Stroke: ECMO can cause stroke due to bleeding in the brain or a blood clot reaching the brain

Contraindications of ECMO Common contraindications of ECMO are as follows:

• Heart, lung or circulatory problems that cannot be fixed even after transplants
• When there is brain or liver damage,
• Uncontrolled bleeding in the brain