ECMO (Extracorporeal Membrane Oxygenation)

The ECMO machine provides life support to the body when a person’s heart or lungs are too sick to do the job. ECMO is for people with extremely severe lung or heart disease.

What is ECMO?
Why do I need ECMO?
What are the risks of having ECMO?
What happens during ECMO?
What happens after ECMO?

What is ECMO?

ECMO stands for Extracorporeal Membrane Oxygenation. ECMO is a therapy for people who have serious forms of heart and lung disease.

Like a heart-lung machine used in heart surgery, ECMO temporarily takes over the work of the lungs and/or the heart. The machine adds oxygen to the blood and then pumps the oxygen-rich blood back through the body.

ECMO doesn’t cure lung or heart disease. The therapy provides time for the lungs or heart to rest and recover while the disease is treated.

The ECMO machine is made up of tubing, a pump, an oxygenator and a heater.

The two most common types of ECMO are:

  1. Veno-arterial (VA) – used for people with severe heart or severe heart and lung disease. Blood is drained from the body’s venous system and returned to the body’s arterial system. ECMO support is provided to both the heart and the lungs.  
  2. Veno-venous (VV) – used for people with severe lung disease. Blood is drained from the body’s venous system and returned to the body’s venous system. ECMO is only required to support the lungs.

Why do I need ECMO?

ECMO can be provided for people of all ages who have illnesses which severely impact the function of the lungs or heart, such as:

People with severe lung or heart disease who are waiting for a transplant may also be given ECMO.

Below, you can watch a short video from one of our doctors explaining more about ECMO.

 

Below, you can watch an animation explaining what happens during ECMO.

What are the risks of having ECMO?

There are some risks involved with ECMO. Risks include:

  • Bleeding
  • Blood clots or air bubbles forming in the tubes
  • Increased chance of stroke
  • Irregular heart rhythms
  • Kidney failure
  • Poor blood flow in the limbs
  • Swelling.

Discuss these risks with your doctor, and be sure to ask questions if you are unsure of anything.

What happens during ECMO?

  • You will usually be given medicine to make you sleep and relax
  • A specialist doctor will insert plastic tubes into large veins and/or arteries inside your legs, neck or chest - these tubes will be connected to the ECMO machine
  • The team will take X-rays to check that the tubes are in the right place
  • The ECMO machine takes blood containing low levels of oxygen from your body to a pump and then to an oxygenator
  • The oxygenator adds oxygen and removes carbon dioxide, similar to the function of the your lungs
  • This oxygen-rich blood is then warmed and returned to the your body
  • You will also be connected to a ventilator which helps the lungs to heal.

Whilst you are asleep, nutrition and medications are given through tubes to prevent blood clots and infections, keep you comfortable, and help support your body and its functions.

ECMO can be used for days, weeks or on rare occasions months, depending on your condition. You will stay in the intensive care unit in the hospital and will usually remain asleep. The specialist doctor and ECMO team will continue to monitor you closely.

When your lungs and/or heart are ready, the doctors will slowly reduce the amount of support to see how your lungs and heart are working.

If your condition remains stable, the ECMO tubes can be removed. 

You will be asleep while the doctor removes the tubes and repairs the blood vessels and skin where the tubes were inserted. You will also remain on the ventilator after the ECMO is removed until you are able to breathe on your own.

What happens after ECMO?

After the ECMO therapy is finished, you will recover in the intensive care unit of the hospital. The medical team will plan your next steps and recovery.

Even after the ECMO and ventilator have been removed, there still may be lots of work to be done before you can go home. If you’ve had ECMO for a long time, you are likely to be very weak and will need to participate in a rehabilitation program to regain your strength.

You may also need to have follow up appointments with members of your medical team, including doctors, nurses, physiotherapists, social workers, speech therapists, occupational therapists and dietitians.

It’s important to keep an eye on the site where the ECMO was inserted to check that they are healing well. Contact your doctor if you notice any redness or swelling. 

Remember - if, at any time, you have questions about your procedure or recovery, don’t hesitate to contact a member of your health team.