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Extracorporeal membrane oxygenation (ECMO) — also known as extracorporeal life support (ECLS) — is a type of artificial heart and lung machine that oxygenates a patient’s blood outside the body. It’s used to provide short-term breathing and blood circulation support for patients with cardiopulmonary failure (failing heart, lungs or both). It’s often a lifesaving measure for vulnerable patients, giving their health care teams extra time to further assess their condition, treat an underlying issue and/or arrange for lung or heart transplantation.
ECMO works to replace the function of the heart or lungs in a similar way to how dialysis can take the place of failing kidneys. It uses a unique process of removing carbon dioxide from the patient’s blood and then returning oxygenated blood to the patient. Most people require ECMO for three days to several weeks, although some will need to be on ECMO for a longer period of time.
Most people who undergo ECMO have acute lung injury (such as severe bacterial or viral pneumonia). Your heart specialist may also recommend ECMO if you have acute cardiac failure, including problems such as massive myocardial infarctions and myocarditis, or after difficulties in recovery after heart surgery.
If you’ve used a ventilator (breathing machine) or hemodynamic support (to restore adequate blood circulation) along with medications but haven’t had significant improvement in your cardiopulmonary function, your specialist may recommend you try ECMO.
When a person is on a ventilator due to serious health issues, their lungs can become damaged by the high pressures and levels of oxygen required to support bodily processes. Using the ECMO system gives a person time for their body to recover while allowing the heart or lungs to rest. This provides better patient outcomes and a better quality of life for the person after they leave the hospital.
If you’ve undergone surgery and your care team determines that you need life support so your heart or lungs can heal, you may need to undergo ECMO. Your doctor and respiratory therapists will provide you with details on what you can expect and how to prepare for ECMO.
Your doctor inserts a cannula (thin, flexible tube) into one of your veins to draw out blood. A second tube that runs into another vein or artery returns warmed, oxygenated blood to your body. You will receive sedation medication to help you relax during the procedure. You may not be able to talk while you’re undergoing ECMO. Depending on your situation, you may need to receive ECMO for a few days or up to a few weeks.
How well your body responds to ECMO depends on how severe your condition was prior to starting treatment, as well as other factors. Your doctor and care team will provide details on the results you may expect.
Ohio State is one of a handful of centers in the Midwest that can provide this treatment option to patients who are very sick and experiencing either cardiac or respiratory failure. Ohio State Wexner Medical Center has extensive experience managing a large number of ECMO patients annually, including the most complicated patients who can’t be managed at other centers. Our team is experienced and capable of managing complex, end-stage cardiopulmonary failure right here in Columbus.
Ohio State Richard M. Ross Heart Hospital is home to a highly skilled and experienced ECMO team, which includes 24/7 management by our team of cardiac surgeons and cardiac surgical intensivists. While ECMO offers temporary support, Ohio State Wexner Medical Center offers the full spectrum of advanced therapies, including ventricular-assist devices and heart and lung transplantation.
With newer technology, we have the ability to transport patients on ECMO from other hospitals. This technology allows our level 1 shock program to provide the entire range of advanced therapies to treat patients with acute cardiopulmonary decompensation (deterioration).