Extracorporeal Membrane Oxygenation (ECMO)
What is Extracorporeal Membrane Oxygenation (ECMO)?
ECMO is an advanced technique where your blood is withdrawn from a large vein in your body, then passed through a pumping mechanism and a device that adds oxygen and removes carbon dioxide. Your blood is then returned to your circulatory system and circulated throughout your body. ECMO is a potential short-term treatment for cardiac and respiratory failure resulting from such things as heart attack, infection, pneumonia, trauma or smoke inhalation.
The ECMO machine acts as a form of life support, maintaining blood flow and oxygenation to your body’s vital organs while your heart and lungs rest. We can support you on ECMO as long as your heart and lungs need to recover, or until a transplant becomes available.
Currently ECMO is offered at UCHealth University of Colorado Hospital (UCH). UCH is a leader and innovator with rehabilitation on ECMO, with the ability to take on high-risk patients. On average, UCH performs 70-90 ECMO cases a year, which is the most in Colorado and among the top tier for ECMO centers nationally.
Advanced heart and respiratory care
ECMO gives cardiac and respiratory support when a patient’s heart and lungs are not working properly enough to sustain life. ECMO is similar to heart-lung bypass machines used during open-heart surgery.
An ECMO Center of Excellence
UCHealth University of Colorado Hospital has been named an ECMO Center of Excellence – Gold by the Extracorporeal Life Support Organization (ELSO). The Award of Excellence signifies a commitment to exceptional patient care.
When is ECMO used?
ECMO is used for:
- Respiratory failure or acute respiratory distress syndrome (ARDS) resulting from a virus, pneumonia, trauma, or a blood clot in the lungs.
- Cardiac failure after a heart attack, heart surgery, or a heart procedure in the cath lab.
- Someone waiting for a transplant or VAD (ventricular assist device) who has severe lung disease or heart failure that cannot be cured.
In certain situations ECMO is not an option for a patient. For example:
- When a patient is not able to get a transplant or VAD and has severe lung disease or heart failure that cannot be cured.
- When a patient has suffered a severe brain injury from: a serious stroke, not getting enough oxygen to the brain (anoxic brain injury).
- When a patient is suffering from an illness that has no cure, such as end-stage cancer, and has a poor outcome even if ECMO is helpful and works.
Types of ECMO
VV ECMO takes over the work of the lungs only by adding oxygen to the blood. The patient’s own heart must be able to pump oxygen-rich blood through the body. Both cannulae are in veins. Some patients may start on VV and need to switch to VA.
VA ECMO takes over the work of the heart and lungs. It adds oxygen to the blood and pumps for the patient’s heart. It provides the greatest life support. One cannula drains blood from a vein, and the other returns blood into an artery.
Your ECMO team
ECMO therapy is complex and not without risk, which is why there are so many people involved in ensuring that patients on ECMO receive the best care possible. At UCHealth an entire team of trained medical professionals is dedicated to ECMO care:
Registered nurses (RNs)
- The nurses are responsible for most of the physical assessment and bedside care.
- The nurses also give and make changes to medicines as ordered.
- The nurses can answer many of your questions, or find the answer.
- Many doctors will oversee the ECMO care of your loved one. At UCH, we have resident doctors who are gaining experience as well as attending doctors who are experts in their fields. Both will help care for your loved one.
- Nurse practitioners and physician assistants also work with doctors. They specialize in care for the cardiothoracic ICU (CTICU).
- Doctors visit patients each day with the care team. Family is invited to join these visits. This is best time to bring up any issues or concerns you may have, so the doctor can address them.
Perfusionist and ECMO specialist
- Perfusionists and ECMO specialists are specially trained to use ECMO machines. They work closely with the doctor in taking care of the blood exchange.
- ECMO specialists are at the bedside at all times. They have been trained to manage the ECMO circuit and equipment.
- Perfusionists and ECMO specialists can answer any of your questions about the ECMO circuit and equipment.
Respiratory therapists (RTs)
- Patients on ECMO support often have issues with breathing that cannot be solved by ECMO alone.
- Oftentimes they have tubes and a machine that help support breathing.
- Ask an RT if you have any questions about therapy used to help with breathing.