Exploring ECMO: The Mechanisms Behind Life-Saving Support

An individual whose heart, lungs, or both aren’t functioning properly may benefit from extracorporeal membrane oxygenation, or ECMO. An artificial lung membrane is used in conjunction with a variety of devices to continually pump blood out of your body, provide oxygen, and remove carbon dioxide. The machine then pumps the blood back into the body.  ECMO therapy can be very helpful in allowing the heart and lungs to rest and heal following a severe respiratory infection, heart attack, or chest/cardiac damage. Extracorporeal life support (ECLS) is a type of ECMO. It is used to treat lung and heart diseases that could be fatal. ECMO may be used in care for COVID-19, acute respiratory distress syndrome (ARDS), and other infections.

Dr. Sheetu Singh is a leading expert in the field of Extracorporeal Membrane Oxygenation (ECMO), providing invaluable guidance on its clinical applications and management. She has devoted her professional life to developing ECMO procedures and enhancing patient outcomes. She has a wealth of knowledge in critical care medicine. Her thorough comprehension of the difficulties associated with ECMO therapy enables her to instruct patients and medical personnel on the nuances of the process, including risk assessment, patient selection, and post-ECMO care.

As a key player in the medical community, Dr. Sheetu Singh dedication to ECMO research and innovation has made her a valuable asset. She makes sure that the most recent developments are successfully incorporated into clinical practice to improve patient care.

Cough Specialist, Chest Specialist, Sleep Apnea Specialist, Asthma Specialist, Lung Specialist

How Does ECMO Function?

An ECMO system can help critically ill patients since it helps support their heart and lungs. These outcomes are possible as a result:

• Reduces the strain on the lungs and heart, enabling them to heal.
• Maintains life during medical operations like surgery.
• Helps someone while they wait for a transplant.
• Aids infants are born with hearts or lungs that weren’t fully developed.

Different Types of ECMO

There are two different ECMO therapies: Venovenous (VV) ECMO, which only supports lung function, and Venoarterial (VA) ECMO, which supports both heart and lung function.

• VA ECMO

The main way the mechanism functions is by letting the patient’s blood flow through the circuit without going via the heart. VA ECMO supports both the heart and lungs. By withdrawing blood from a major vein and rerouting it into a large artery, VA ECMO enables oxygen-rich blood to travel throughout the body even in situations where the heart is unable to pump it.

• VV ECMO

Since VV ECMO oxygenates blood without pumping it, the patient’s heart must be able to sustain the body during this procedure. Two cannulas are placed into veins close to or inside the heart to enable blood to return to the body at one location and do away with the need for two entrance sites. Blood from ECMO comes back to the body prior to the heart pumping it all across the body.

When Can ECMO Machines Be Used?

1. Major Respiratory Issues: Lung injury that results in acute respiratory distress syndrome impairs the lung’s capacity to take in oxygen and expel carbon dioxide from the blood. This may occur when:

• Respiratory issues, including the flu, COVID-19, Pneumonia.
• The lungs are damaged by sepsis.
• Burns as well as respiratory injuries. Burning hot air from a fire, smoke, toxic gasses, and toxic chemicals can all cause damage to the lungs.
• Overdose on drugs.
• Pancreatic inflammation can cause the body to release toxins and substances that could damage the lungs.
• Ingesting liquids, water, food, vomit, or both, and drowning or aspirating these things into the lungs. 
• Breathing problems. 

2. Heart Problems: You might need to have ECMO treatment if you have heart damage as a result of trauma or other diseases or conditions. A few of these are:

• Heart attack.
• Trauma, such as from a fall or car accident, can cause the heart muscle to bruise and become damaged.

3. Infants: Treating neonates and infants with heart and lung problems, especially premature infants, sometimes involves the use of ECMO.

Operations and Transplants

When a patient is unable to get a specific type of therapy or treatment, ECMO can serve as a “bridge.” When a patient is in the waiting period for a lung or heart transplant, or in any of the following situations:

• Organ Transplantation.
• Lung and Heart Surgery.
• Post-Surgery Recovery.
• Organ Donor’s Support.

Benefits of ECMO Machine

An ECMO system can help critically ill patients since it helps support their heart and lungs. These outcomes are possible as a result:

• Lessens the strain on the lungs and heart, enabling these organs to heal.
• Keeps oneself alive during surgery and other medical procedures.
• Helps someone while they wait for a transplant.
• Helps babies whose hearts or lungs were not fully developed at birth.

Risk Factors Arising From Using an ECMO Machine 

Despite being a very helpful medical equipment, an ECMO machine comes with some very real hazards. 

• Everyone on ECMO needs blood thinners because to the risk of blood clots developing. Additionally, clots that become stuck in the ECMO circuit may cause disruptions to blood flow.
• The need for tubes to enter large veins and arteries might make you more vulnerable to bleeding.
• Any cut on your skin has the potential to get infected, and the tubes of an ECMO circuit may also harbor bacteria. An infection might spread throughout your body more easily as a result of this.
• Strokes can emerge from spontaneous bleeding in the brain during ECMO assistance, or they can occur from clots in the circuit that end up moving to the brain.
• The ECMO circuit as a whole might shut down due to mechanical breakdown in any one component.

FAQs

What is ECMO?

Extracorporeal Membrane Oxygenation (ECMO) is a life-supporting technique that replaces the heart and lungs. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest and heal.

Who needs ECMO?

Patients with severe heart or lung failure who have not responded to standard therapies are usually placed on ECMO. Patients with illnesses such as severe pneumonia, heart failure, or ARDS (acute respiratory distress syndrome) frequently utilize it.

How does ECMO work?

The process of ECMO involves taking blood from the patient, allowing it to pass through an oxygenator (an artificial lung) that replaces carbon dioxide with oxygen, and then putting the oxygen-rich blood back into the patient. This process temporarily replaces the function of the heart and/or lungs.

Is ECMO the same as a ventilator?

No, ECMO is different from a ventilator. Air is moved into and out of the lungs with the assistance of a ventilator; nevertheless, ECMO performs the functions of the heart and, if necessary, the lungs. When a ventilator is insufficient, it is utilized in more serious situations.

What are the risks of ECMO?

The risks associated with ECMO are the same as those associated with any invasive procedure: bleeding, blood clotting, infection, and problems from anticoagulation (blood thinners). However, ECMO can be lifesaving when conventional treatments are insufficient.