In intensive care medicine, extracorporeal membrane oxygenation (ECMO) is a technique of providing oxygen to patients whose lungs are so severely diseased that they can no longer serve their function.
An ECMO machine is similar to a heart-lung machine. To initiate ECMO, cannulas are placed in large blood vessels to provide access to the patient's blood. Anticoagulant drugs (usually heparin) are given to prevent blood clotting. The ECMO machine continuously pumps blood from the patient through a "membrane oxygenator" that imitates the gas exchange process of the lungs, i.e. it removes carbon dioxide and adds oxygen. Oxygenated blood is then returned to the patient.
ECMO can provide sufficient oxygenation for several days or even weeks, allowing diseased lungs to heal while the potential additional injury of aggressive mechanical ventilation is avoided. It may therefore be life-saving for some patients. However, due to the high technical demands, cost, and risk of complications (such as bleeding under anticoagulant medication), ECMO is usually only considered as a last resort therapy.
The ECMO machine continuously pumps blood from the patient through a "membrane oxygenator" that imitates the gas exchange process of the lungs, i.e.
ECMO is most commonly used in NICU's (Neonatal Intensive Care Units), for newborns in pulmonary distress.
Management of the ECMO circuit is done by a team of ECMO specialists made up of respiratory therapists and/or nurses that have received training in this specialty.
ECMO may eventually prove to be an appropriate therapy for certain premature neonates, but the risks for this population appear greater and the benefits less certain at this time.
ECMO team members are drawn from several specialties and tasks are performed by members of more than one specialty with the key supervisor, for example, being sometimes a pediatric intensivist, sometimes a neonatologist, and sometimes a pediatric cardiac surgeon.
ECMO seems susceptible to such pressures, especially since the existence of superior neonatal intensive care is often advertised as a reason that prospective mothers should choose a hospital’s obstetrical unit.
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