ECMO
What is ECMO ?
Extra-Corporeal Membrane Oxygenation (ECMO) is a life saving advanced intensive care technology that is used when a child/adult has a condition which prevents the lungs or heart from working properly. It involves a machine that will take over the work of the heart and lungs (modified heart – lung machine in ICU) until they get better. It is used only when all other therapies fail or stop working.
ECMO can support the patient for days to weeks.
The ECMO technology has a proven track record in a variety of conditions especially with respect to children and requires a dedicated team of medical and paramedical experts with round the clock bedside care.
The ECMO set up involves the vascular cannulae, the blood pump (controls blood flow), oxygenator (oxygenates blood and removes carbon dioxide), blood warmer and tubing’s through which the blood flows.
Veno Venous VV ECMO is used for only respiratory failure and Veno Arterial VA ECMO for cardiac failure.
ECMO Pump
Since it involves controlled systemic anticoagulation it should be used only in appropriate patients, at the appropriate time by well-trained persons.
ECMO Cannulas with ICD
Who should be considered for ECMO?
- Acute Respiratory Distress Syndrome (ARDS) secondary to pneumonia, aspiration, severe air leak
- Refractory Septic / Cardiogenic Shock
- Myocarditis – viral, scorpion sting
- Post Arrest shock
- Before or after cardiac surgery
- Meconium Aspiration
- Congenital Diaphragmatic Hernia
- Persistent Pulmonary Hypertension
- Poisoning
When should ECMO be considered?
It should promptly be considered in patients with life threatening Respiratory or Cardiac Failure that does not respond to conventional intensive care management. Patients who benefit from ECMO have a reversible condition.
The Apollo Multispecialty Hospitals, Kolkata ECMO club
The Club comprises of the following specialists who are an integral part of any ECMO team – cardiothoracic surgeons, perfusionists, vascular surgeon, intensivists, anesthetists, ID specialists, lab services, blood bank, hematology, nephrology, staff, physiotherapists, and dietitians.
The team meets on the second Wednesday of each month. The purpose of the club is to ensure quality, regular auditing and ongoing education of junior fellows and staff responsible for care of an ECMO patient