Extracorporeal Membrane Oxygenation (ECMO) is a sophisticated treatment for those who suffer from serious and life-threatening diseases which prevent the heart or lung from functioning as they should. Sometimes referred to as an esophagus machine for the heart, what is extracorporeal membrane oxygenation assumes the role of the lungs, and sometimes the heart, allowing the essential organs time to relax and recover.
The technology is commonly employed for Intensive Care Units (ICU) in cases where traditional treatments like medication and ventilators are no longer efficient. ECMO has become an essential treatment in patients who suffer from illnesses like acute respiratory distress syndrome (ARDS) or cardiogenic shock, and those recovering from major lung or heart operations.
Why is ECMO Used?
If the lungs are damaged to supply oxygen or eliminate carbon dioxide, and/or when your heart has become weak to effectively pump blood, ECMO could be used as an interim life-saving bridge. It gives physicians the an opportunity to tackle the root disease and prepare patients for surgery, or transplant.
Common Scenarios Where ECMO is Applied:
- Insufficiency with severe pneumonia or ARDS
- COVID-19-inducing respiratory failure
- Heart attacks that cause cardiogenic shock
- Support for post-cardiac surgery
- Pulmonary embolism
- Trauma-related lung injuries
- Preparation for organ transplants and recuperation
How Does ECMO Work?
Understanding of what is extracorporeal membrane oxygenation
The ECMO machine operates through the pumping of blood out of patient’s body into the artificial lungs (membrane oxygenator) which increases oxygen levels and eliminates carbon dioxide. The oxygen-rich blood is returned to the body of the patient and bypasses the lung or heart.
Types of ECMO:
- Veno-Arterial (VA) ECMO: Supports both heart and lung function. The blood is removed from an artery and returned to an arterial.
- Veno-Venous (VV) ECM: Supports the lung’s sole function. Blood is removed from and then returned to the vein.
ECMO Circuit Components:
- Cannulae (tubes) placed into blood vessels
- Pump for circulation of blood
- Oxygenator to provide oxygen and remove carbon dioxide
- Heat exchangers to keep the blood temperature
The ECMO Procedure
Patient Selection
Not all patients are eligible for ECMO. It is typically reserved for patients who are seriously ill after all other treatments have been unsuccessful. A multidisciplinary team reviews the potential risks and benefits.
Cannulation
Large cannulae are placed into veins or arteries, usually in the chest, neck or the groin. This is a sterile surgery, which is typically performed under anesthesia or sedation.
Monitoring and Management
Once patients are on ECMO patients require continuous surveillance:
- Carbon dioxide and oxygen levels
- Heart rate and blood pressure
- Organ function (kidneys and livers, brain)
- Infection and bleeding risk
Weaning Off ECMO
If the condition is beginning to improve the medical team will begin to decrease ECMO support. If lung and heart function improve, ECMO can be discontinued.
Benefits of ECMO
- Gives you time to recover allows the lungs or heart to heal, while maintaining oxygen levels.
- The bridge to surgery or transplant Patients remain stable until the next procedure is possible.
- Reversible and effective in conditions For example, viral infections or temporary heart dysfunction.
Risks and Complications of ECMO
Although ECMO could save lives but it’s also a risky procedure. The potential risks include:
- Bleeding (due to the blood thinners that are used to stop clotting within the circuit)
- Infections (from chronic cannulation)
- Air embolisms or blood clots
- Organ damage
- Neurological impairment or stroke
- Failure of mechanical components in ECMO components
Thus, it is usually utilized in centers with staff who are trained and monitored continuously.
ECMO and COVID-19
The COVID-19 pandemic was a time when ECMO was recognized as a last resort treatment for patients suffering from serious viral pneumonia as well as ARDS. While it’s not an option for solution, ECMO helped improve survival rates for a select group of patients when ventilators and medications did not work.
ECMO Survival Rates
The survival rates differ based on the condition of the patient, the patient’s age, the duration of ECMO usage, and the experiences in an ECMO center. On average:
- The survival rate for the VV-ECMO (lungs only) About 60-70 percent
- Rates of survival in VA-ECMO (heart and lung) around 40-50 percent
Results are much more favorable when ECMO is initiated early and utilized in high-volume specialization centers.
Who Performs ECMO?
Highly skilled staff is responsible for ECMO treatment, which includes:
- Intensivists (critical care physicians)
- Surgeons in cardiothoracic surgery
- Perfusionists (specialists who run an ECMO machine)
- Therapists for respiratory therapy
- Specialized ICU nurses
This team is working around all hours to tweak the settings, deal with issues, and monitor the progress of recovery.
After ECMO: Recovery and Rehabilitation
After weaning is successful patients could face a lengthy process of recovery. Rehabilitation consists of:
- Physical therapy
- Therapy for respiratory problems
- Support for the psychological
- Check-ups with cardiologists and Pulmonologists
A few patients may suffer lasting effects like weakening of the muscles scarring of the lung, neurological problems, however many are able to return to normal lives in time.
Conclusion
What is Extracorporeal Membrane Oxygenation (ECMO) is a groundbreaking method that has revolutionized the way of providing intensive care to seriously sick patients. It is a vital aid when the heart or lungs fail, allowing the possibility of recovery or surgery or a transplant.
Although it does come with dangers, ECMO remains a beacon of hope in the modern world of medical treatment for patients with serious lung or heart conditions that can be life-threatening.
If you or a loved ones are suffering from severe cardiac or respiratory problems Ask your doctor whether what is extracorporeal membrane oxygenation is a viable option. Also, make sure that it is administered at an accredited, experienced ECMO center.
