ECMO is a type of life support given to people whose hearts or lungs are affected by a life-threatening condition or accident. Blood flow is maintained throughout the body, and ECMO supports blood gas balance (oxygen and carbon dioxide).
Lung or heart failure cannot be treated with ECMO; instead, it temporarily gives a ‘break’ to the functions of these body organs. During extracorporeal membrane oxygenation (ECMO), blood is pumped outside your body to a heart-lung machine, eliminating carbon dioxide before returning oxygen-rich blood to your body’s tissues. The membrane oxygenator in the heart-lung machine receives blood from the right side of the heart, rewarms it, and then returns it to the body.
This technique enables the heart and lungs to rest and recover because the blood can “bypass” them. Likewise, ECMO is used in critical care conditions when your heart and lungs require healing assistance. It can treat infections, including ARDS, COVID-19, and others.
Heart, Lungs, Oxygen, and Carbone dioxide
For proper cell activity, the body needs oxygen in every cell. To keep the tissues and organs alive and functioning correctly, the heart circulates oxygen through the blood as it pumps. Resultantly, blood circulation removes carbon dioxide from the blood and transports it to the lungs, exhaling it out of the body.
Significance of ECMO
People with severe heart and lung diseases, awaiting a heart transplant, or recovering from a heart transplant may benefit from ECMO. More specifically, it can be an alternative when other life-support attempts have failed. While ECMO cannot diagnose, treat, or cure an illness, it can be beneficial when your body is temporarily unable to give your tissues adequate oxygen. Following are some of the benefits of ECMO;
Some heart diseases that may benefit from ECMO treatment include;
- Chest pain (acute myocardial infarction)
- Cardiovascular disease (decompensated cardiomyopathy)
- Muscle inflammation in the heart (myocarditis)
- Life-threatening infection response (sepsis)
- Decreased body temperature (severe hypothermia)
- Complications following a transplant
- The shock brought on by insufficient blood flowing from the heart (cardiogenic shock)
Some lung (pulmonary) disorders that may benefit from ECMO treatment include;
- Syndrome of acute respiratory distress (ARDS)
- Pulmonary artery obstruction in the lungs (pulmonary embolism)
- Coronavirus disease (COVID-19)
- Diaphragm problem (congenital diaphragmatic hernia)
- In the womb, the fetus inhales waste materials (meconium aspiration)
- Flu (influenza)
- Pulmonary hantavirus syndrome
- High pulmonary blood pressure (pulmonary hypertension)
- Respiration difficulty
Who can get benefit from ECMO treatment?
Doctors may advise ECMO for patients suffering from severe injury or infection, cardiac arrest, lung failure, or heart failure. Moreover, doctors can employ it to stabilize a seriously ill patient while diagnosed or beginning treatment. It can maintain blood oxygenation and circulation specifically for those patients awaiting a heart or lung transplant.
Working of Extracorporeal membrane oxygenation (ECMO):
A Perfusionist is an expert in using ECMO equipment for therapy in the intensive care unit (ICU). He continuously observes the patient while modifying the ECMO machine’s settings.
After patients’ sedation, caretakers insert plastic tubes called cannulas into the patient’s prominent veins and arteries in the leg, chest, or neck. These cannulas will connect the ECMO machine.
Blood is removed through one cannula and drained into a bladder-like plastic pouch. In replacement of the heart, the blood is pumped via the ECMO device and then pushed via a membrane oxygenator (an artificial lung). This machine functions similarly to the lungs by adding oxygen to the blood and eliminating carbon dioxide. Moreover, a ventilator and a breathing tube can be utilized simultaneously.
After passing through the artificial lung, blood goes via a heat exchanger to be heated to body temperature and re-enter the body through the different sizable cannula.
It is possible to administer drugs to ECMO patients to calm them down, manage their pain, and maintain their blood thin. While some patients receive sleep aids, others are awake throughout ECMO treatment and can move around and interact carefully. Parenteral nutrition can be given to the patient by an intravenous line or directly through a feeding tube into the digestive system (enteral).
ECMO treatment is frequently used in the intensive care unit (ICU). The device is connected to the monitors so that caretakers may check whether it’s operating correctly and adjust accordingly. ICU staff members closely monitor the patient’s heart rate, blood pressure, and gas levels.