ECMO Center

The ECMO team at Driscoll Children's Hospital also offers a rapid-deployment device. This device called a rescue circuit, is used for rapid resuscitation of children for many reasons including cardiac arrest. It is designed for easy set up and can be ready to use within 3 minutes. In 1999, the ECMO team at Driscoll Children's Hospital had a 71% survival rate for cardiac and respiratory ECMO's combined.

Frequently Asked Questions about ECMO
(Extracorporeal Membrane Oxygenation )

What is ECMO?

ECMO stands for Extracorporeal Membrane Oxygenation. ECMO is a form of therapy that can support heart and/or lung function when a patient's own heart and/or lung function is inadequate. The technology of ECMO is similar to the heart-lung bypass techniques used in cardiovascular surgery. Blood drains by gravity from the patient through a tube (catheter) placed in a large neck vein. This blood passes through a plastic pouch, or bladder, and then in pumped through the membrane oxygenator that serves as an artificial lung, putting oxygen into the blood and removing carbon dioxide. The blood then passes through a heat exchanger that maintains the blood at normal body temperature. Finally, the blood reenters the body through a large catheter placed in an artery in the neck.

How Is Someone Placed On ECMO?

There are two different ways for ECMO to support your child. The first method is called venoarterial or VA bypass. VA ECMO will support the heart and lungs. To place someone on VA ECMO, a small operation is performed on the right side of the neck. One cannula is placed in the right atrium of the heart (filling chamber) and a second cannula in the aorta (main artery of the body).

The second method is called veno-venous or V V bypass. This is used for lung support only. This type of ECMO requires only one catheter to be place through the right side of the neck. This procedure is done in the PICU. Cannulas are placed through the right side of the neck because ECMO requires the use of the big blood vessels that are near the heart. At the same time your child is being canulated, a specially trained ECMO specialist, sets up the ECMO circuit. It is primed with blood that is carefully tested and cross-matched for compatibility with your child's blood type.

What Does ECMO DO?

ECMO is designed to support lung and heart function when your child's lung and/or heart function is inadequate. ECMO does not cure lung disease, it merely supports your child to allow time for the lungs and/or heart to rest.

How Long Will Someone Have to Stay On ECMO?

ECMO is usually continued for three to 21 days depending upon the severity of your child's condition. The decision to discontinue ECMO is made after careful evaluation of your child's lung and heart function by all physician's involved in your child's care.

What Are The Complications Of ECMO?

Bleeding is the most common complication of ECMO, and this is a problem associated with the use of Heparin, an anti-clotting medication, which must be used. Although bleeding can occur in any part of the body, bleeding is most serious when it occurs in the brain as this can cause brain damage or death. A head ultrasound will be done every day to look for signs of bleeding. If your child does experience a brain bleed, ECMO may have to be stopped because the continued use of Heparin increases the risk of further bleeding and the potential damage to the brain. Mechanical failure is another potential complication. The ECMO circuit is composed of many parts, all connected into a closed, smoothly flowing system. If any of the parts malfunction, there is the risk of blood loss or the introduction of air into the system, which could cause death or damage to any of the organs, including the brain. An ECMO specialist will be at the bedside at all times. This person has been trained to deal with all emergency situations. In addition, there are back-up components for all ECMO equipment.

What Are A Person's Chances of Survival After ECMO?

It is not possible to specifically state the chances of survival. The survival chances must be individualized with careful consideration of the cause of the lung and/or heart disease, the hospital course before ECMO support, and the course while on ECMO. Remember that ECMO is only offered to children who have a potential for healthy survival.

What Chances Does Someone Have For A Normal Life After ECMO?

ECMO is offered to children who have a chance for healthy survival, but there are several potential long-term problems that can occur. These include chronic lung disease and neurological problems.

Will My Child Need Follow-Up Care?

Yes. Even though the heart or lung disease is better now, your child may have significant exposure to low oxygen levels prior to ECMO. This places your child at higher risk for developmental problems. These potential problems can be determined only as your child grows. We suggest that your child be brought to a follow-up clinic here or near your home. Your ECMO coordinator will talk to you about your follow-up care before you leave our hospital. They will also be able to answer your questions about this process.