Extracorporeal Membrane Oxygenation (ECMO) is an emergency procedure employed when a patient’s cardiac and lungs cannot perform as they should by themselves. This treatment is a breakthrough that provides long-term oxygen and cardiac support through causes for extracorporeal membrane oxygenation of blood in the body via the use of a machine, which allows the vital organs rest, and heal.

ECMO is not an effective treatment, but rather it’s a bridge to help doctors address the root cause of heart or respiratory problems. Knowing the reasons behind ECMO is crucial, since it is generally only employed in emergency situations.

Why Is ECMO Used?

ECMO is generally thought of when traditional methods such as mechanical ventilation or drugs are no longer efficient. It can be used by children and adults, especially in the intensive health unit (ICUs). Patients can be put on ECMO for days, hours or even weeks dependent on the severity of the illness.

Understanding the factors that cause the patient to require ECMO can assist caregivers, families, and healthcare professionals recognize important situations in advance and react in a timely manner.

Causes for Extracorporeal Membrane Oxygenation

Here are the most common medical reasons that could make a patient require ECMO assistance:

Severe Respiratory Failure

One of the main causes for extracorporeal membrane oxygenation can be acute respiratory distress (ARDS). When this happens the lungs are filled with fluid. the air sacs in the lungs which reduce oxygen exchange. The causes of ARDS could include:

Pneumonia (bacterial or viral)
Sepsis (systemic infection)
COVID-19 pneumonia
Inhalation from stomach contents lung
Smoke inhalation or near-drowning

In such instances the veneo-venous ECMO (VV-ECMO) can be employed to help support lung function by oxygenating blood and eliminating carbon dioxide from the external.

Severe Cardiac Failure

If the heart isn’t able to supply enough blood to satisfy the body’s requirements Veno-arterial ECMO (VA-ECMO) will be used. This type of therapy is able to support both lung and heart functions.

Common heart conditions that could necessitate ECMO are:

Cardiogenic shock
Massive heart attack (myocardial infarction)
Myocarditis (inflammation of the heart muscle)
Severe arrhythmias (irregular heartbeats)
Heart failure not responsive to medicines

Patients who have had major heart surgeries might require ECMO to provide a temporary support system for recovery.

Post-Cardiac Arrest

In the event of a sudden cardiac arrest, in which the heart ceases to beat suddenly, ECMO may be initiated in conjunction with or following CPR (cardiopulmonary Resuscitation). This is referred to by the term ECPR (extracorporeal cardiac resuscitation).

If conventional CPR is not able to restore proper circulation ECMO is a last-resort measure to save lives.

Pulmonary Embolism (PE)

A pulmonary embolism is when blood clots block one or more arteries within the lung. It can cause sudden cardiac and respiratory collapse. ECMO provides immediate support by ensuring circulation and oxygenation while the treatment is carried out to eliminate or dissolve the blood clot.

Congenital Heart Defects (in Infants and Children)

In infants and newborns, ECMO is often used to treat congenital heart diseases. There are babies born with heart defects which prevent the lungs or heart from working properly.

ECMO can serve as a bridge between:

Corrective surgery
Heart transplant
Recovery following trauma relating to birth

Disorders such as hypoplastic left-heart syndrome (HLHS) or transposition of the great blood vessels (TGA) might be a reason to consider ECMO intervention as early as the first years of life.

Meconium Aspiration Syndrome (in Newborns)

Meconium aspiration happens when a newborn inhale meconium (early stool) and amniotic fluid at the birth. It can block airways and trigger severe respiratory discomfort.

When ventilators stop working, ECMO can help oxygenate the baby’s blood as the lungs heal.

Sepsis and Septic Shock

Sepsis is a potentially life-threatening reaction to infection which could result in organ damage, organ failure and even death. In the worst instances, patients suffer from Sepsis, a condition in which blood pressure falls dangerously low and organs start to fail.

ECMO can be utilized to ensure that oxygen is delivered to vital organs during most critical stages of septic shock.

Trauma or Major Surgery Complications

ECMO can be utilized in the event of a serious trauma, like:

A chest injury that is not visible
Massive blood loss
Lung contusions

Similar to the situation, complications after or following major surgeries particularly thoracic or cardiac surgery, can result in the necessity for ECMO.

Risk Factors That Can Lead to ECMO Usage

Although the reasons listed above can be medical emergency situations, certain patients suffer from risk factors that increase their likelihood to need causes for extracorporeal membrane oxygenation in the most critical circumstances. This includes:

Age of advanced or very young age (neonates)
Lung or heart disease with underlying causes
Immunocompromised status
Recent major surgery
Chronic diseases like diabetes or kidney disease

Being aware of these risk factors in the early stages assists in proactive planning and prompt intervention.

Conclusion

Extracorporeal Membrane Oxygenation is a highly effective and life-saving technique that is used only in the most dire situations. The reasons for ECMO can range from severe respiratory failure to cardiac arrest, to congenital problems and Septic shock. It is crucial to respond quickly when faced with life-threatening situations because ECMO frequently serves as a bridge for the recovery process, surgery or even transplantation.

If your loved one has been placed on ECMO knowing the root reason and treatment plan may provide some clarity and optimism. As medical technology and technology improve, ECMO continues to save lives once thought to be not able to be saved.