October 9, 2024
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Introduction
Extracorporeal Membrane Oxygenation (ECMO) is an advanced life-support technology used for severe heart and lung conditions when traditional treatments aren’t sufficient. We connect with experienced physicians who take time from their busy schedules to offer expert guidance and support the community. In this article, Dr. Madhan Kulandaiswamy, MBBS, MD., DM( cardiac anaesthesia), explains ECMO and answers key questions to help people understand when and why it might be needed.
What is ECMO and When Is It Used?
ECMO provides critical support for whose heart and lungs are unable to function properly on their own. It works by pumping blood outside the body to an artificial lung (membrane) where oxygen is added, and carbon dioxide is removed. The oxygen-rich blood is then returned to the body, allowing the heart and lungs to rest and heal.
Uses: ECMO is often used in cases of severe pneumonia, heart failure, respiratory distress syndrome, or during recovery from complex heart surgeries. It can serve as a temporary bridge to recovery or other interventions like a heart transplant.
Duration: ECMO is generally a short-term solution, used for a few days to weeks, depending on the patient’s condition and response to treatment.
Key Questions and Answers About ECMO
What is ECMO and how does it work?
Extracorporeal membrane orygenation (ECMO) is a machine that helps patient,
whose heart or lungs are too weak to function on their own .It’s a type of life support that temporarily takes over the heart and lung function , allowing them to rest.
It works by pumping blood outside the body to an artificial lung (membrane)where oxygen is added, and carbon dioxide is removed. The oxygen rich blood is then returned to the body, allowing the heart and lungs to rest and heal.
When is ECMO recommended for any patient?
A doctor may recommend ECMO for a patient when they have a condition that affect their heart or lungs and standard treatments aren’t working.
It can help patients with a range of severe condition, from cardiac arrest to respiratory failure. But in most case, ECMO therapy is used only when all other conventional treatment have failed to resolve the underlying heart or lung disorder.
How long can a patient stay on ECMO?
The length of time a patient stays on ECMO depends on their condition and how they respond to treatment. ECMO is usually continued until the underlying cardiac or lung problem improves or is resolved.
The typical duration in around five days, but some patients may need to be on ECMO for upt 25 to 30 days.
What conditions anyone typically require ECMO?
ECMO is a type of advanced life support that can be used for a variety of condition, including
Heart and lung failure
Cardiac arrest
Acute respiratory distress syndrome (ARDS)
Cardiogenic shock
Pulmonary embolism
Birth defects of the heart
Covid 19
ECMO can also be used as a bridge to other treatments,such as heart assist devices or lung transplants.
What are the risks of ECMO treatment?
Patients who are recommended for ECMO therapy are very sick, they are already at high risk of complications, including death. ECMO therapy itself comes with its own set of risks including
Bleeding: ECMO patients may bleed due to medications that prevent blood clots in the tubing.
Infection : Patients on ECMO are at risk of bloodstream infections because cannulas are inserted into their veins and arteries.
Blood clots : Patients on ECMO are at risk of developing blood clots, which can lead to stroke, pulmonary embolism, or deep venous thrombosis.
Kidney failure : Patients on ECMO may not circulate enough blood to their kidneys, which can lead to kidney failure.
Limb ischemia : Patients on ECMO may experience loss of blood supply in their hands, feet, or legs.
Air bubbles : Small air bubbles may form in the tubing.
How is ECMO different from mechanical ventilation?
ECMO and mechanical ventilation are both used to treat patients with breathing or heart conditions, but they work in different ways .
A ventilator moves air in and out of the lungs when a patient is unable to get enough oxygen on their own.
An ECMO machine circulate blood through machine to remove carbon dioxide and addoxygen . It is used to treat life threatening heart and lung failure, and can be used to lower the intensity of mechanical ventlation.
How long does it take for a patient to recover after ECMO ?
Recovery time for patients who have been treated with ECMO varies depending on a number of factors including their conditon.
Time on ECMO
Weaning off ECMO
ICU Stay
Discharge
Recovery time
Some patient may be on ECMO for less than 24 hours, while other may need to be on it for over 30 days.
Most commonly, patients on VA ECMO for 5-10 days and VV ECMO for 10 – 14 days but these are just averages and are not meant to be reflective of one’s condition.
Can ECMO be used for newborns and children?
ECMO can treat a variety of severe heart and lung conditions in patients of all age, including infants, childen and adults. Some conditions that ECMO can help with include
11)What happens to the heart and lungs while on ECMO?
While on extracorporeal membrane oxygenation (ECMO), the heart and lungs are allowed to rest and heal as the ECMO machine takes over their function.
Can ECMO be used for patients at home?
No, Extracorporeal Membrane Oxygenation (ECMO) is a life-support therapy that is typically used in intensive care units and is not suitable for home use. But we at Dr.Madhan’S ECMO Health Care Pvt Ltd are putting our efforts in future to do this new concept in india and we are working on it
What are the long-term effects after ECMO treatment?
Long-term effects of Extracorporeal Membrane Oxygenation (ECMO) treatment can include
>Neurological disorders
>Cognitive impairment
>Physical impairments
> Organ failure
> Pulmonary limitations
> Mental health diagnoses
While long-term mortality and morbidity are still significant, survival and quality of life have improved in recent years. Most patients who are weaned from ECMO are able to return home and work.
How do doctors decide when to stop ECMO?
A doctor’s decision to stop extracorporeal membrane oxygenation (ECMO) is based on a number of factors, including the patient’s condition and response to treatment.
- Patient improvement
If the patient is improving, the ECMO team may reduce support or remove ECMO for a short time to see if the patient can tolerate it.
- Patient trial
The ECMO team may perform a weaning trial to see how the patient responds to gradually decreasing support over several hours. The patient is monitored closely during this time for signs of instability.
Once at “low flow,” or idling, the patient can be taken off ECMO for a “wean,” during which the patient is assessed to determine whether he/she is ready to come off ECMO.
What emotional and physical support is available for families during ECMO treatment?
ECMO can be stressful and upsetting to you and your family. It’s important to take time to rest and take breaks from visitation at times in order to practice self-care. Case managers and social workers are on staff to assist and support you. We encourage you to seek counselling or psychiatric help if you and your family feel that it is needed. This experience can be very difficult for many people.
We are available to provide supportive resources and help you navigate this difficult time.
Conclusion
ECMO is a powerful tool that can provide life-saving support for children with severe heart and lung conditions. While it is typically used as a last resort, it offers hope for recovery when other treatments are not enough. Dr. Madhan Kulandaiswamy emphasizes the importance of understanding ECMO, its risks and benefits, and working closely with the medical team during this critical time. For more expert advice and support, visit HealthHOD.com, where physicians provide free guidance to families facing complex medical challenges.
Learn more on HealthHOD.com
Understood. It does the job of human heart. Ecmo provides oxygen to the blood and circulates the oxygenated blood.