Extracorporeal membrane oxygenation (ECMO)

Overview

In extracorporeal membrane oxygenation (ECMO), blood is pumped outside of the body to a heart-lung machine. The machine removes carbon dioxide and sends oxygen-rich blood back to the body. Blood flows from the right side of the heart to the heart-lung machine. It's then rewarmed and sent back to the body.

ECMO lets blood go around the heart and lungs. This allows the heart and lungs to rest and heal.

ECMO is a form of extracorporeal life support (ECLS). It's used is for life-threatening heart and lung conditions. ECMO may be used in care for COVID-19, acute respiratory distress syndrome (ARDS), and other infections.

Why it's done

ECMO may be used to help people who have conditions that cause heart or lung failure. It also may be used for people who are waiting for or recovering from a heart transplant or lung transplant. Sometimes it's used when other life support measures haven't worked.

ECMO does not treat or cure diseases. But it can give short-term help when the body can't provide the tissues with enough oxygen and blood flow.

Some heart conditions in which ECMO may be used include:

• Complications from a heart transplant.
• Heart attack, also called acute myocardial infarction.
• Heart muscle disease, also called cardiomyopathy.
• Heart that can't pump enough blood, called cardiogenic shock.
• Low body temperature, called hypothermia.
• Sepsis.
• Swelling and irritation of the heart muscle, called myocarditis.

Some lung conditions in which ECMO may be used include:

• Acute respiratory distress syndrome (ARDS).
• Blood clot that blocks and stops blood flow to an artery in the lung, called pulmonary embolism.
• COVID-19.
• Fetus breathing in waste products in the womb, called meconium aspiration.
• Hantavirus pulmonary syndrome.
• High blood pressure in the lungs, called pulmonary hypertension.
• Hole in the muscle between the chest and the belly area, called congenital diaphragmatic hernia.
• Influenza, also called flu.
• Pneumonia.
• Respiratory failure.
• Severe allergic reaction called anaphylaxis.
• Trauma.

Risks

Possible risks of ECMO include:

• Bleeding.
• Blood clots.
• Clotting disorder, called coagulopathy.
• Infection.
• Loss of blood supply in hands, feet or legs, called limb ischemia.
• Seizures.
• Stroke.

How you prepare

ECMO is used when life support is needed after surgery or during serious illness. ECMO can help your heart or lungs so you can heal. A healthcare professional decides when it may be helpful. If you need ECMO, your healthcare professionals, including trained respiratory therapists, prepare you.

What you can expect

Your healthcare professional puts a thin, flexible tube, called a cannula, into a vein to draw out blood. A second tube goes into a vein or artery to return warmed blood with oxygen to your body. You get other medicines, including sedation, to make you comfortable during ECMO.

Depending on your condition, ECMO might be used from a few days to a few weeks. Your healthcare team talks with you or your family about what to expect.

Results

ECMO outcomes vary. Your healthcare team can explain how helpful ECMO may be for you.