ECMO is a means of supplying patients with insufficient
blood perfusion in the body or gas exchange in the lungs with lung and heart
help. Until it is restored to provide oxygen to the tissues and organs, blood
is pumped from the body into an artificial lung, oxygenating red blood cells
and extracting excess carbon dioxide.
When will Extra Corporporeal Membrane Oxygenation be used?
Extra Corporporeal Membrane Oxygenation may be requested by
patients for a variety of reasons, but they will typically experience serious
acute lung or heart failure and have not responded to traditional therapy.
Guidelines released by the Extracorporeal Life Support Organization suggest
that ECMO is considered only when a 50 percent mortality risk is already
expected for the patient and is typically indicated at 80 percent.
It’s very costly to keep patients on ECMO for long periods
of time, and only of benefit if the patient is likely to recover from the
experience. Therefore, other variables are often considered, such as the
existence of pre-existing conditions, the patient’s age and height, and the
futility of the procedure.
The Food and Drug Administration (FDA) permits the use of
ECMO for continuous use for up to six hours during medical procedures or
transport, and for longer periods of respiratory support. Many Extra
Corporporeal Membrane Oxygenation recommended patients undergo extreme cardiogenic
shock, which is when the heart is unable to pump enough blood to meet the needs
of the body, typically after a severe heart attack.
The next most considered category for Extra Corporporeal
Membrane Oxygenation involves patients with biventricular heart failure and
extreme hypoxemia who have not benefited from other treatments. During Extra
Corporporeal Membrane Oxygenation, careful patient monitoring is crucial, as
although it can relieve pressure from the central veins, right atrium, and
right ventricle, the left atrium is under increased pressure due to infusion
into the aorta, so the risk of developing ischemia-mediated necrosis is
increased for patients with poor contractile heart function.
Extra Corporporeal Membrane Oxygenation is only used as a
temporary support mechanism for patients who are either expected to heal
spontaneously, such as those with myocarditis, or who are undergoing
transplantation or other major procedures. Systemic inflammatory response
syndrome, vascular injury, and stroke are common complications, so alternatives
such as ventricular assist devices are still considered. Only Extra
Corporporeal Membrane Oxygenation, however, provides carbon dioxide removal and
blood oxygenation, so it is necessary in cases requiring lung support.