How does ECMO support work?

The ECMO is connected to the patient’s blood circulation. This is done via cannulas that are inserted in the operating theatre or in the intensive care unit. The site where the cannulas are placed depends on the clinical picture, the weight of the patient and the vascular situation. The neck and groin vessels or, after cardiac surgery, the large vessels in the thorax come into question. The ECMO system – consisting of the tube system, the pump (“artificial heart”) and the artificial lung (oxygenator) – is then connected via the cannulas. Now the heart or lungs can be relieved and have a chance to recover. Usually, the patient is also connected to a ventilator via a tube in the windpipe.

Is the patient conscious during ECMO therapy?

During ECMO therapy, the patient lies in a drug-induced deep sleep or is only lightly sedated with medication, depending on the disease and the position of the cannulas.  All patients receive adequate pain therapy.

How is the patient fed during ECMO therapy?

Infants are fed their usual milk formula via a stomach tube. Older children receive tube feeds or sometimes special nutritional infusions via the vein.

How long does ECMO therapy last?

If cardiovascular failure has occurred previously, the patient can recover after only a few days. If lung failure was the starting point for ECMO therapy, recovery can take several weeks.

What are the risks of ECMO therapy?

Blood clots and resulting vascular occlusions are a risk factor of ECMO therapy. To avoid excessive activation of blood clotting by the ECMO system and thus the formation of clots, the blood must be diluted with heparin. On the other hand, this can cause bleeding at the cannulation site, in the surgical area or in the brain and other organs. A transfusion of blood products at the beginning and during the course of therapy is usually necessary.

How successful is ECMO therapy?

Depending on the patient’s age and previous illness, the chances of survival from ECMO therapy are 60 to 70 per cent for lung failure and 43 to 53 per cent for heart failure (ELSO Registry Report international summary, July 2019). By participating in the ELSO (Extracorporeal Life Support Organisation) registry, a worldwide organisation for organ replacement therapies, a regular international exchange takes place with the aim of constantly improving therapy and quality assurance.