This life-saving therapy is for patients who’ve had heart and/or lung failure, heart surgery or who are awaiting transplants.
What is ECMO?
Extracorporeal membrane oxygenation, or ECMO, is an advanced therapy that delivers healthy oxygen to the blood, similar to a heart-lung machine used during surgery. This process takes place outside the body using a machine that pumps out bad blood, oxygenates it and then pumps healthy blood back through the body.
ECMO works like an oxygenation machine to help a heart that has trouble pumping enough oxygenated blood to the body, or lungs that are unable to supply red blood cells with enough oxygen and remove carbon dioxide. It can support a damaged heart or lungs:
- After recovering from surgery
- After recovering from illness or disease
- During a surgical procedure
- While a person is waiting for a transplant
Although it typically doesn’t cure heart or lung disease, ECMO gives much-needed time to help a person’s heart and lungs heal.
Here’s how ECMO works
During a surgical procedure, your doctor will place special tubes called ECMO cannulas into one or more large veins or arteries in your neck, chest or leg. These cannulas connect you to the ECMO machine. Using a pump, the tubing filters blood through the machine to remove carbon dioxide and replaces it with oxygen-rich blood. The pump and cannulas then return the blood back to your body.
“We’re seeing more and more instances in which ECMO can be used to treat very sick patients, sometimes in cases when other treatments have not worked,” says Evan Gajkowski, ECMO coordinator for Geisinger. “For patients dealing with serious heart or lung-related conditions, ECMO may be the best course of action to help their bodies heal.”
During ECMO therapy, you’ll be given blood thinners to prevent your blood from clotting as it moves through the machine. Your oxygen and carbon dioxide levels will also be measured using an arterial blood gas test. This provides important data to the ECMO care team monitoring your treatment.
Because ECMO is doing the work for your lungs or heart, the machine can be adjusted as needed, allowing your body to heal while you’re treated or wait for a transplant.
“Having ECMO therapy is not painful,” Gajkowski notes. “Once a person is connected to the ECMO machine, they’ll receive medication or sedatives as needed and be closely monitored. We’re here at every step to keep patients comfortable and loved ones informed.”
He adds that most people who are on an ECMO machine may only need it for a few hours or days. The average person stays on ECMO for seven days, but depending on your condition, therapy may be needed for a few weeks.
What are the different types of ECMO?
ECMO therapy can help children or adults. There are two different types:
- Veno-arterial (VA) ECMO – This treatment provides support to both the heart and lungs. Tubes will be connected to both an artery and a vein.
- Veno-venous (VV) ECMO – This treatment provides support for the lungs only. The machine will be connected only to veins.
What is ECMO used for?
ECMO is used for severe and life-threatening illnesses, often when traditional treatments aren’t responding. You or a loved one may be a good candidate if you’ve experienced:
- Respiratory failure
- Heart failure
- Lung failure
- Heart surgery
- Severe asthma
- Lung infection
- Severe flu or pneumonia
- Near-drowning event
- Awaiting a lung or heart transplantation
You’ll receive a full evaluation from our ECMO team to determine whether this treatment is right for you.
ECMO therapy at Geisinger
We’re here to get you the best care possible — as quickly as possible. You or your loved one can rest assured you’re receiving optimal care as the Geisinger ECMO program has been designated an ECMO Center of Excellence. Our dedicated ECMO team will determine whether ECMO is a good fit for you. We’ll be here to answer any questions you or your loved ones might have and guide you through the process.
Using ECMO to treat those with COVID-19
Symptoms of the novel coronavirus (which causes COVID-19) can range from mild to severe. In the most severe cases, sometimes a person may need to be put on a ventilator, a machine that does the breathing for them while their lungs heal. However, if a person’s lungs are badly affected, a ventilator may not be able to deliver enough oxygen. This is where ECMO support may be an option.
ECMO treatment acts as an artificial lung, oxygenating the blood outside the body so blood doesn’t need to transfer through the damaged lungs. The therapy allows their lungs to rest while their body fights COVID-19.
A highly trained team that includes critical care medicine doctors, ECMO doctors and nurses, respiratory therapists, intensive care nurses, perfusionists and cardiac surgeons works together to care for those on ECMO.
“ECMO treatment isn’t without risks and will not be an option for everyone, but it has helped save the lives of several of our COVID-19 patients,” says Gajkowski.