When a person’s heart and lungs no longer function properly or need a break to recover from a serious illness, a mechanical method known as ECMO may be used to keep them alive.
ECMO, or extracorporeal membrane oxygenation, pumps blood through a device that adds oxygen to it and then pumps it back into the patient’s body, performing the function of the heart and lungs. ECMO, which can be used for both adults and children, provides long-term management of heart and/or lung failure while the patient recovers or awaits a transplant or ventricular assist device.
ECMO is sometimes also called ECLS, or extracorporeal life support.
ECMO is ideal for patients whose cardiovascular health is compromised, who are at a high risk of dying, or who would not be able to maintain their current physical status if they were placed on traditional mechanical ventilation. ECMO can be used while the patient is awake, alert and able to move around, which greatly reduces the risk for complications related to immobility and ventilator use. Patients with acute respiratory distress syndrome (ARDS) or cardiogenic shock who do not have multisystem organ failure are among those who qualify for ECMO. Providers may use a variety of criteria to determine whether a patient is a good candidate for ECMO.
ECMO can be used in two different ways – venovenous (VV) and venoarterial (VA).
Venoarterial (VA) method
Venoarterial ECMO takes blood from a central vein or the right atrium of the heart and pumps it past an oxygenator worn outside the body. The blood then returns under pressure to the aorta to be pumped out to the body. This method helps support the amount of blood that is pumped by the heart (cardiac output).
Venovenous (VV) method
Venovenous ECMO takes deoxygenated blood from a large vein, passes it through the oxygenation process and returns it to the body through another large vein. This form does not support cardiac output of the heart but it allows for the removal of carbon dioxide through the oxygenator unit and doesn’t just add oxygenated blood alone.
Patients receiving ECMO will have a large catheters (tubes) placed in the body to remove and replace the blood volume after gas exchange. Because of the risk of blood clots, patients on ECMO are given anticoagulant drugs (blood thinners) to reduce the risk of clot formation and complications.
ECMO has been used for decades in newborns and children with lung failure, pneumonia, meconium aspiration syndrome and other conditions. More recently, it has proven to provide beneficial support for adult patients with severe respiratory and/or cardiac failure, allowing for recovery of the heart or lungs or acting as a bridge to transplantation or ventricular assist devices.
UK is the only center in Kentucky offering adult ECMO transport – in fact, you’d have to travel more than three hours in any direction – as far east as Charlottesville, as far north as Indianapolis, as far west as Nashville – to find another center with the same service. Learn more about this unique service offered by UK HealthCare.
UK HealthCare’s ECLS program has been awarded the Gold Level Center of Excellence from the Extracorporeal Life Support Organization (ELSO). The award recognizes the neonatal, pediatric, and adult ECLS teams at UKHC for their commitment to exceptional patient care.
The ELSO Award for Excellence “recognizes ECLS programs worldwide that distinguish themselves by having processes, procedures and systems in place that promote excellence and exceptional care in extracorporeal membrane oxygenation.”
The ECLS program at UKHC is truly interdisciplinary and this award recognizes the contributions made by all departments which include CT Surgery, Cardiology, Critical Care Medicine, ECMO Specialists, Perfusion, CVICU staff, PT, OT, Pharmacy, and Palliative Medicine.