When is ECMO used?
ECMO is an option for those patients who have acute, life-threatening failure of the heart and/or lungs that is 1) not responding to other types of support and 2) felt by the patient's physicians to likely be reversible (i.e. treatable). In cases of severe lung problems, ECMO would be considered when the lungs are so injured and sick that mechanical ventilators (breathing machines) are either failing or have such high settings that they may cause the lungs further harm or damage. ECMO functions as the patient's lungs until the lungs have hopefully healed enough for the ventilator to again provide adequate support for the patient. ECMO does not replace treatments such as antibiotics or medications that help to remove edema/fluid from the lungs. The sole purpose of ECMO is to "buy time" for the patient's lungs to heal from whatever disease process got them sick in the first place.
Likewise, ECMO can be used to help a failing heart provide enough blood flow to the body to support vital organ function. This may sometimes be necessary either before or after heart surgery, or in cases of disease that seriously weaken the heart muscle's ability to pump blood. Sometimes a patient's heart is so weak that a heart transplant must be considered. If that is the case, ECMO may be used to help pump blood to the patient's vital organs until a transplanted heart is obtained. This is called a "bridge" to a transplant. ECMO provides ample blood flow and oxygen to major organs like brain, liver, and kidneys helping them to maintain function during the child's illness. At Arkansas Children's Hospital, ECMO has been successfully used for conditions such as:
- Severe Pneumonia
- Meconium Aspiration Syndrome (MAS)
- Pulmonary Hypertension (PPHN)
- Congenital Diaphragmatic Hernia (CDH)
- Life-threatening Asthma Attacks
- Septic Shock
- Bridge to Heart Transplant
- Supportive Treatment Before Cardiac Surgery
- Supportive Treatment After Cardiac Surgery
- Sudden Cardiac Arrest