ECMO stands for extracorporeal membrane oxygenation. In this process, your veins are drained, the blood is pumped extracorporeal (outside the body), the carbon dioxide is taken out, the oxygen is added, and the blood is pumped back into your body. This surgery relieves some of the stress on your heart, lungs, or both.
The two primary ECMO therapies are as follows-
- Blood that has been oxygenated is returned to veins via venovenous (VV) ECMO, where it travels through your lungs. Doctors will use it when your heart is healthy, but your lungs aren’t.
- Blood is redirected to the arteries via venoarterial (VA) ECMO. Your lungs are not the place where it goes. Doctors generally use this when a patient has both heart and lung issues.
How to Get Ready for ECMO therapy?
You will have tubes inserted by a surgical team into your legs, groyne, neck, chest, or significant veins or arteries. The clinician may refer to the tubes as cannulae and the process as cannulation.
It is typically done in your hospital room. First, you’re given medication to reduce discomfort, prevent blood clotting, and promote sleep (this is referred to as sedation). A surgeon will then install the tubes. The team then does an X-ray to confirm the tubes are positioned correctly.
If you need ECMO therapy, you are usually already using a ventilator or a breathing aid. Specially trained nurses and breathing therapists will monitor your recovery alongside your surgery team. They’ll frequently check your blood pressure, oxygen and carbon dioxide levels in your blood, heart rate, and blood pressure.
You shouldn’t feel any severe pain or discomfort while the ECMO machine is running or the tubes are being put in. A sleeping aid will be administered to you while you are receiving ECMO. However, you might be awake enough to converse if you are not on a ventilator.
When Is an ECMO therapy Required?
You could need ECMO therapy if:
- Your lungs cannot supply the body with enough oxygen, even with extra.
- Your lungs cannot expel enough carbon dioxide, even with a ventilator.
- Your heart cannot pump blood through your body quickly enough.
- Your heart and lungs need help while you wait for an organ transplant.
Disease or injury cannot be cured with ECMO therapy. It is a device to support your body while your medical team works to address the underlying issue, which may be a chronic illness like COPD, an infection like COVID-19, or even trauma from an accident.
Generally speaking, your medical team will work to get you off the ECMO machine as soon as possible, possibly within a few hours. For some, the need lasts longer. There are many time frames, from a few days to weeks. Stopping ECMO use could be fatal for certain persons.
Risks of ECMO therapy
ECMO treatment carries the following two critical risks:
Bleeding: Up to 50% of those undergoing ECMO may be affected, which could be harmful. Blood thinners prescribed for ECMO may make issues worse. Incisional wounds from surgery or another factor could be to blame. Surgery could be necessary to find the problem and solve it. Verify for any internal bleeding (haemorrhaging).
Blood clots: These can break apart and travel to your brain or lungs, which might be catastrophic. Although some ECMO patients may experience blood clots, your medical team can often prevent problems by continuously monitoring you and rapidly treating any clots that form in your body or the ECMO system’s tubes.
The ECMO Therapy- A Brief
ECMO is an invasive technique. A medical expert will insert a thin, flexible tube called a cannula into a vein. Since removing blood is its primary function, this cannula is also a drainage cannula. A second cannula will also be inserted in order to return warmed and oxygenated blood to the body.
ECMO may be helpful for patients who have undergone surgery or have significant cardiac or lung conditions.
ECMO has shown to be quite effective in infants. Newborns are the critical age group for whom ECMO therapy is markedly superior to conventional therapy. Neonatal illnesses necessitating ECMO include primary pulmonary hypertension (PPHN), idiopathic PPHN, meconium aspiration syndrome, respiratory distress syndrome, hypoxia, and congenital diaphragmatic hernia (CDH).
Over time, ECMO has undergone a considerable procedural shift. Now that its benefits are more understood, ECMO is widely employed as rescue therapy. Many H1N1/2009 (commonly known as swine flu) patients with ARDS and refractory hypoxemia have been kept alive because of ECMO.
Conclusion
ECMO therapy may gradually decrease once medical professionals successfully treat the underlying heart or lung disease. In collaboration with the patient and the medical team, the perfusionist lowers the ECMO machine’s settings to allow the patient’s heart and lungs to take over.
It is done gradually and with great care to ensure that the patient’s heart and lungs usually function. The team takes out the cannulas and seals the entry points into the body when the ECMO is no longer required. To know more, contact Max Healthcare.
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