What Is ECMO?

An ECMO machine is used as a support system after someone experiences critical respiratory or cardiac failure. There are two kinds of ECMO machines, depending on whether the heart or lungs need the most support:

• Veno-arterial (VA-ECMO): Acts as a bypass for the heart, taking blood from one side of the heart, removing CO2, reoxygenating it, and returning it to the other side to keep the heart beating. Used to support the heart and the lungs, with primary support focused on the heart.
• Veno-venous (VV-ECMO): Acts as a bypass for the lungs, taking blood from a large vein, removing CO2, reoxygenating it, and returning it to the vein. Used only as a support system for the lungs, and the patient’s heart must be functioning properly to pump the oxygenated blood.

When Is ECMO Used?

Following an extreme cardiovascular or respiratory incident, an ECMO machine can give the organ time to recover or the care team more time to determine the best course of action for the patient.

Extreme cardiovascular or respiratory incidents that may require ECMO support include, but are not limited to:

• Acute respiratory distress syndrome (ARDS)
• Cardiac arrest
• Cardiogenic shock (following a heart attack)
• COVID-19
• Influenza (flu)
• Pulmonary embolism

In some cases, an ECMO machine may be used as life support while a patient awaits an organ donation.

What Can Patients Expect?

Patients are typically sedated while being connected to an ECMO machine, making the process safer and more comfortable. The machine is connected via two small tubes inserted into the veins in the neck or groin.

Further sedation is determined on a case-by-case basis. Patients are typically awake; however, they may be sedated for discomfort or safety reasons.

Depending on their condition, patients can typically be supported by ECMO for anywhere from one to three weeks.