The Role of ECMO in Critical Care

Although use of ECMO carries certain complications, its potential benefits can be pivotal in saving lives in critical care.

Extra Corporeal Membrane Oxygenation (ECMO) is a pinnacle of life support, whenever any patient is critically ill with worsening multiple organ dysfunctions especially when lungs and heart are failing. It is basically the best technology that can give hope to those patients, who are having critical illness which can be reversed. This modality had really helped in good recovery of some critically ill patients of COVID pneumonia, during COVID-19 pandemic.

Dr. Kaladhar. S, Senior Consultant and HOD Critical Care Medicine, Yashoda Hospitals Hyderabad, elaborates on the role of ECMO in critical care.

What is ECMO?

It basically involves a technique, wherein the bad blood (venous) is taken out from the patient body through a cannula placed in the big vein and it will be pumped into an artificial lung (oxygenator). This oxygenated blood is returned back to the patient through another cannula. Hence, the functions of the heart and lungs will be taken care by the ECMO, which can rest and heal.

In which conditions ECMO can be used?

ECMO can be used in conditions like severe Acute Respiratory Distress Syndrome (ARDS), secondary to severe pneumonia of the lungs or any other insult, severe heart disease with shock (e.g peripartum cardiomyopathy, myocarditis, heart attack etc.). In some cases of cardiac arrest (ECPR), it can be lifesaving.

What are the different types of ECMO?

There are two types. V-V (Veno-venous) ECMO supports only lungs, when severe ARDS is present. VA (Veno-Arterial) ECMO supports both heart and lungs, where both are diseased. The choice of which type to be used depends on the specific illness and the nature of organ failure involved.

What are the risks and complications of ECMO support?

As ECMO is a complex procedure, it inherently carries certain complications associated with its use. These can be severe bleeding anywhere in the body, infections, clotting of blood, etc.

But most of the times these can be prevented if specialized ECMO team is involved, who will monitor very closely.

ECMO is emerging as a technology in patients with multiorgan failure, where timely institution of this support can lead to miraculous and exceptional recovery of certain patients. Although it is associated with risks, its potential benefits can be pivotal in saving lives in critical care.