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Saint Thomas Heart

ExtraCorporeal Membrane Oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is a medical procedure providing both cardiac and respiratory support to people whose heart and lungs cannot function.  

In the past, this procedure has primarily been used on children, but it is seeing more use in adults with cardiac and respiratory failure. The ECMO machine works by removing blood from the person's body, removing the carbon dioxide, and oxygenating the red blood cells. ECMO is used for heart or lung failure only when all standard medical therapies have been exhausted and the patient cannot survive without it.

The use of ECMO falls into two broad categories: Support of the patient with the failing heart (VA or venoarterial ECMO), and support of the patient with failing lungs (VV or venovenous ECMO). 

The ECMO machine is a much simpler and miniaturized version of the heart-lung bypass machine used in open-heart surgery. It pumps and oxygenates a patient's blood outside the body, allowing the heart and/or lungs to rest. When connected to an ECMO circuit, blood flows through tubing to an artificial lung in the machine that adds oxygen and removes carbon dioxide; then the blood is warmed to body temperature and pumped back into the patient’s body.

When is ECMO used?

  • When a patient’s lungs are no longer able to sustain the oxygen and carbon dioxide demands of the body
  • When a patient’s heart can no longer pump eough blood to sustain life
  • Bridge to Recovery: Ideally the heart or lung failure is reversible and the patient spends a period of time on ECMO and then the device can be removed
  • Bridge to LVAD or heart transplant: If the heart failure is irreversible, ECMO is used as a bridge to a LVAD or heart transplant
  • Bridge to lung transplant: If lung failure is irreversible, ECMO can occasionally be used as a bridge to lung transplant.
  • For support during high-risk procedures in the cardiac catheterization lab