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Dr. Keshavamurthy CB

Consultant - Cardiology - Interventional

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Dr. Keshavamurthy CB

Consultant - Cardiology - Interventional

Manipal Hospitals, Mysuru

ECMO - A Life-saving Technology

Posted On: May 18, 2023

blogs read 5 Min Read

Heart Specialist Hospital in Mysore

Extracorporeal membrane oxygenation (ECMO) is primarily used to support heart and lung failure patients. An ECMO machine can save the lives of critically ill patients when appropriately used. It is a cutting-edge device that has recently transformed critical care treatment. A patient is placed on the ECMO machine and managed by a specially trained medical team under the supervision of an interventional cardiologist in Mysore.

What’s the Significance of ECMO?

ECMO is a life-saving machine that assists patients with severe respiratory or cardiac disorders who may not respond to conventional therapies. The patient's heart or lungs may rest and recuperate with ECMO while the machine pumps blood to an artificial oxygenator, acting as a bridge to full recovery. It can also be used as a bridge to transplantation as ECMO can maintain the heart and lung function from a few days to several weeks by which time, the organs will recover or the patient is sent for a transplant of the appropriate organ. The reason why a patient needs ECMO will determine how long they need to be on it. So, the ECMO machine is crucial in giving severely sick patients assistance that can save their lives.

What Are the Key Uses of ECMO Machine?

The ECMO machine is primarily used in respiratory and cardiac failure cases. It can assist in saving the lives of patients suffering from severe respiratory disorders that severely compromise lung function, cardiogenic shock following a heart attack, or low heart function. The ECMO machine takes on the role of the lungs in cases of respiratory failure by helping to oxygenate the blood and remove carbon dioxide from the body. It is commonly employed in ARDS (Acute respiratory distress syndrome) - a situation in which the lungs suffer serious damage and are unable to supply enough oxygen to the body. In situations of cardiac failure, ECMO is also utilised to pump oxygenated blood to the body in place of a failing heart and maintain adequate circulation.

How to Use ECMO Machine?

Using an ECMO machine is a complex and specialised procedure requiring significant training and expertise. Here is a general overview of the steps involved in using an ECMO machine:

  • Patient Preparation

The patient is assessed before deciding if the patient qualifies for ECMO assistance. The patient is typically sedated and intubated (a breathing tube is placed into the airway) once the choice to use ECMO has been made.

  • Cannulation

Large tubes called cannulae are inserted into the patient's veins and/or arteries during cannulation. These cannulae are connected to the ECMO machine and serve as conduits for blood flow. Cannulation can be performed using various techniques, including percutaneous (through the skin) or surgical.

  • Priming

The ECMO machine is then primed with saline solution and heparin to prevent blood clotting. To reheat the blood to body temperature, the machine is additionally linked to a heat exchanger.

  • Initiation of ECMO

The ECMO machine is turned on, and blood is redirected from the patient's heart and lungs to the machine once it has been primed and the cannulas have been inserted. The engine pumps blood, oxygenates, warms it to body temperature and then returns to the patient's body via cannulas.

  • Monitoring and Management

Respiratory therapists, critical care doctors, and ECMO experts are part of the specialised team that must continuously monitor and manage patients on ECMO. The machine settings are reviewed as necessary based on closely monitoring the patient's vital signs.

  • Weaning and Removal

Once the patient's heart or lungs have recovered sufficiently, the ECMO machine can be weaned and removed. This process is carefully managed to ensure that the patient's body can resume normal function.

It's crucial to remember that the procedures for utilising an ECMO machine might change based on the patient's health and the particular ECMO system being utilised. The technique is also extremely risky and demands highly specialised knowledge and skill.

What Are the Advantages of Using an ECMO Machine?

The main advantage of using an ECMO machine is that it provides life-saving support to patients who may not respond to traditional treatments. Other advantages are:

  • The risk of ventilator-associated lung damage, which can happen when a patient uses a ventilator for a lengthy period, can be decreased using ECMO.

  • Additionally, ECMO can lessen the chance of multiple organ failure, which can happen when the heart or lungs are badly injured and cannot oxygenate the body adequately.

  • Continuous vital sign monitoring is possible with ECMO, enabling the early identification and treatment of problems.

The Bottom line

The ECMO machine is a life-saving tool that has recently revolutionised critical care medicine. Patients with severe respiratory and/or heart failure who may not respond to conventional therapies receive crucial assistance from it. ECMO has been demonstrated to considerably increase survival rates in severely sick patients.

FAQs regarding the ECMO Machine

  • What distinguishes an ECMO machine from a ventilator?

At a heart specialist hospital in Mysore, the ventilator is a medical device that assists patients in breathing by giving them oxygen through a tube inserted in their airways. ECMO, on the other hand, takes the place of the lungs by oxygenating the blood outside of the body and also provides circulatory support.

  • How much time can a patient use ECMO?

The severity of the underlying illness and the patient's response to treatment determine how long a patient has to be on ECMO. While some patients only need ECMO for a few days, others can need it for several weeks or months.

  • Is ECMO available in all hospitals?

ECMO is a highly specialised technology that requires significant resources and expertise. Therefore, only larger hospitals and medical centres are equipped with specialised ECMO machines and specialists who can assist patients in need.

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