ECMO : Extracorporeal Membrane Oxygenation

     ECMO (Extracorporeal Membrane Oxygenation) is a vital technology that temporarily takes over the function of the heart and lungs. It's used when these organs fail due to conditions like myocarditis, coronary artery disease, or severe acute respiratory distress syndrome, particularly when standard treatments are ineffective. ECMO provides crucial support, allowing the heart and lungs time to heal or recover.

How ECMO Works

     The ECMO machine acts as an artificial heart, pumping blood, and an artificial lung, exchanging oxygen and carbon dioxide. Deoxygenated blood is drawn from the patient via a cannula, oxygenated by the machine, and then returned to the patient's body. This process is similar to the heart-lung bypass machine used during cardiac surgery.

Indications for ECMO Use

ECMO is indicated for patients experiencing:

• Heart failure or combined heart and lung failure (V-A ECMO).
• Isolated lung failure (V-V ECMO).
• Support during cardiopulmonary resuscitation (ECMO-CPR).

Heart and lung failure can result from underlying diseases or occur as complications following cardiac procedures or surgery.

Potential Complications of ECMO

Complications associated with ECMO may include:

• Bleeding in various organs due to the necessary administration of anticoagulants.
• Infection at the cannula insertion site.
• Stroke due to blood clot formation.
• Limb ischemia (insufficient blood flow to a limb), which can be managed by inserting a separate cannula to perfuse the affected limb.

ECMO Treatment Outcomes

     Patients requiring ECMO have an average survival rate of approximately 50% (according to ELSO data).

Discontinuation of ECMO

     ECMO support can be discontinued, and the cannulae removed, when the heart and lungs recover to near-normal or normal function.

Information by:

Assoc. Prof. Seri Singhathana Kit, M.D.