Extracorporeal membrane oxygenation (ECMO) is when a specially trained medical team uses a machine to do the work that the heart and lungs normally do.
When the heart or lungs stop working, ECMO (EK-moe) can do their job for days, weeks, or even longer.
Often, that's long enough for:
Children can have heart or lung failure for lots of different reasons. ECMO can help kids who have:
The ECMO machine, using a pump that works like the heart, pumps blood from the body through an artificial lung. Like a normal lung, it adds oxygen to the blood and removes carbon dioxide. Then the machine sends the blood back to the child.
The machine is run by an ECMO specialist, who can be:
There are two kinds of ECMO:
Usually during ECMO, medicines keep the child asleep and still. A breathing machine (ventilator) moves air in and out of the lungs to keep them healthy. Sometimes, ECMO can be used while the child breathes on his or her own without a breathing machine.
If a care team thinks ECMO might help your child, they will assess all health problems. The team includes specialists in:
The ECMO doctor or surgeon will talk to you about the risks and likely benefits of ECMO. If you choose ECMO, you will sign a parental consent (permission) form.
Starting ECMO takes several steps. The treatment team:
A mobile ECMO team can safely move (transport) a child who needs ECMO from one hospital to another hospital. ECMO transport is used when:
When a child is in a hospital that doesn't have ECMO, the mobile ECMO team will:
Sometimes, members of the mobile ECMO team may visit the child or use a mobile device to assess the child remotely before sending the full team with ECMO equipment. The ECMO team will decide if ECMO transport and treatment at the other hospital are likely to help the child.
You can stay with your child at least some of the time during ECMO. It helps your child to hear your voice and feel your touch.
How long you can stay depends on how well your child is doing and what kind of medical care is needed. The team will let you know when you can stay and when to step out so they can do tests or treatments to help your child.
A child may be on ECMO from a day to over a month or more. It all depends on the child's health problem.
The care team will do several tests to be sure ECMO is no longer needed, then turn off the machine and remove the tubing. Your child will be eased off the ventilator as he or she adjusts to breathing without ECMO. This may take days or weeks.
Your child might need heart medicines until the heart is fully recovered. The care team will continue to carefully watch your child and give pain medicines to keep him or her comfortable.
ECMO has significant risks. So doctors use it only when they've tried all other treatments and believe that ECMO will help.
Risks include:
ECMO also can have some side effects, like swelling (edema), which is especially common during the first few days. The swelling usually goes away by the time ECMO is finished.
Children need extra support as they recover after ECMO. Some kids may have lung problems if ECMO did the work of the lungs. Others might have some trouble walking or talking, or have a hard time with their schoolwork.
Ask the ECMO team and your child's pediatrician about ways you can help.
Reviewed by: Michael Golecki, RN, BSN, CCRN
Date Reviewed: 01-03-2019