The ECMO team at Driscoll Children’s Hospital offers a rapid-deployment device called a rescue circuit. It 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 three minutes.
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 is then pumped through the membrane oxygenator that serves as an artificial lung, putting oxygen into the blood and removing carbon dioxide. The blood is warmed as it passes through a heat exchanger that maintains the blood at normal body temperature. Finally, the blood re-enters 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 Veno-Arterial, 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 (tube) 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 VV, bypass. This is used for lung support only. This type of ECMO requires only one catheter to be placed through the right side of the neck. This procedure is done in the Pediatric Intensive Care Unit. 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 physicians involved in your child’s care.
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 chance 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.