Extracorporeal Membrane Oxygenation (ECMO) enparentshttps://kidshealth.org/EN/images/headers/KH_generic_header_10_2.jpgExtracorporeal membrane oxygenation (ECMO) is the use of a machine to do the work that the heart and lungs normally do.Extracorporeal Membrane Oxygenation, ECMO, lung transplant, heart transplant, lung failure, heart failure, persistent pulmonary hypertension of the newborn, pneumonia, heart muscle weakness, ekmo, ecmo, ventilator, heart lung machine, cardiomyopathy, Tetralogy of Fallot, HLHS, myocarditis, respiratory distress syndrome, sepsis, perfusion, perfusionist, artificial lung, ECMO machine, cardiothoracic surgery, venovenous, venous-arterial, catheters, cannulas, femoral, pulmonary hypoplasia, transpositon of the great arteries 08/22/201803/08/201909/02/2019Michael Golecki, RN, BSN, CCRN03/01/2019309987fb-cf77-426b-88eb-081f220aa509https://kidshealth.org/ws/RadyChildrens/en/parents/ecmo.html/<h3>What Is ECMO?</h3> <p>Extracorporeal membrane oxygenation (ECMO) is when a specially trained medical team uses a machine to do the work that the heart and lungs normally do.</p> <h3>Why Is ECMO Done?</h3> <p>When the <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/heart.html/">heart</a> or <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/lungs.html/">lungs</a> stop working, ECMO (EK-moe) can do their job for days, weeks, or even longer.</p> <p>Often, that's long enough for:</p> <ul> <li>the medical team to fix the problem, such as with heart surgery</li> <li>the heart or lungs to heal from a problem, such as <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/asthma-basics.html/">asthma</a> or meconium aspiration</li> <li>a child to get a&nbsp;<a href="https://kidshealth.org/ws/RadyChildrens/en/parents/heart-transplant.html/">heart transplant</a> or lung transplant</li> </ul> <p>Children can have heart or lung failure for lots of different reasons. ECMO can help kids who have:</p> <ul> <li>heart failure because of a disease, such as <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/hypoplastic-heart.html/">hypoplastic left heart syndrome (HLHS)</a> or <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/cardiomyopathy.html/">cardiomyopathy</a> (heart muscle weakness)</li> <li>lung failure because of a disease (such as <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/pneumonia.html/">pneumonia</a>, asthma, or&nbsp;<a href="https://kidshealth.org/ws/RadyChildrens/en/parents/meconium.html/">meconium aspiration</a> syndrome) or before a lung transplant for <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/cf.html/">cystic fibrosis</a></li> <li>organs or body systems that didn't develop properly while the baby was in the womb, causing the heart or lungs to fail, such as congenital diaphragmatic hernia or congenital heart disease</li> <li>infections that cause the organs to shut down, such as <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/sepsis.html/">sepsis</a></li> </ul> <h3>What Does an ECMO Machine Do?</h3> <p>The ECMO machine, using a pump that works like the heart, pumps blood from the body through an artificial lung. Like a normal lung, it adds oxygen to the blood and removes carbon dioxide. Then the machine sends the blood back to the child.</p> <p>The machine is run by an ECMO specialist, who can be:</p> <ul> <li>a perfusionist </li> <li>a nurse or respiratory therapist with special training in ECMO</li> </ul> <h3>How Is ECMO Done?</h3> <p>There are two kinds of ECMO:</p> <ul class="kh_longline_list"> <li><strong>Veno-venous (VV) ECMO:</strong> This is used when the heart is working but the lungs need time to rest and heal. It takes blood from a large vein, adds oxygen, removes carbon dioxide, and returns the blood to a vein.</li> <li><strong>Veno-arterial (VA) ECMO:</strong> This is used when both the heart and the lungs need to rest and heal. It takes blood from a large vein and returns it to an artery. The heart continues to beat and pump blood, but doesn't have to work as hard as it did before ECMO started.</li> </ul> <p>Usually during ECMO, medicines keep the child asleep and still. A breathing machine (ventilator) moves air in and out of the lungs to keep them healthy. Sometimes, ECMO can be used while the child breathes on his or her own without a breathing machine.</p> <h3>What Happens Before ECMO?</h3> <p>If a care team thinks ECMO might help your child, they will assess all health problems. The team includes specialists in:</p> <ul> <li><a class="kh_anchor">newborn</a> or pediatric intensive care</li> <li>pediatric surgery</li> <li>lung problems (pulmonology)</li> <li>heart problems (cardiology)</li> <li>heart and chest surgery (cardiothoracic surgery)</li> </ul> <p>The ECMO doctor or surgeon will talk to you about the risks and likely benefits of ECMO. If you choose ECMO, you will sign a parental <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/informed-consent.html/">consent</a> (permission) form.</p> <p>Starting ECMO takes several steps. The treatment team:</p> <ul> <li>puts medicine into the IV so your child will sleep, have no pain, and won't move</li> <li>inserts a breathing tube and attaches it to a ventilator (if your child isn't already using a ventilator)</li> <li>gives your child medicines to keep the blood from clotting</li> <li>places cannulas (long, thin tubes) through an artery and/or vein and guides the tips to the heart</li> <li>uses <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/echo.html/">ultrasound</a> scans or <a href="https://kidshealth.org/ws/RadyChildrens/en/parents/xray-exam-chest.html/">X-rays</a> to be sure that the tubes are in the right place</li> <li>starts ECMO</li> </ul> <h3>What Is ECMO Transport?</h3> <p>A mobile ECMO team can safely move (transport) a child who needs ECMO from one hospital to another hospital. ECMO transport is used when:</p> <ul> <li>a child is in a hospital that doesn't offer ECMO</li> <li>a child must be moved to another hospital for an organ transplant or other care</li> </ul> <p>When a child is in a hospital that doesn't have ECMO, the mobile ECMO team will:</p> <ul> <li>go to the hospital to assess the child</li> <li>start ECMO on the child, if needed</li> <li>continue ECMO while moving the child to the other hospital</li> </ul> <p>Sometimes, members of the mobile ECMO team may visit the child or use a mobile device to assess the child remotely before sending the full team with ECMO equipment. The ECMO team will decide if ECMO transport and treatment at the other hospital are likely to help the child.</p> <h3>Can I Stay With My Child During ECMO?</h3> <p>You can stay with your child at least some of the time during ECMO. It helps your child to hear your voice and feel your touch.</p> <p>How long you can stay depends on how well your child is doing and what kind of medical care is needed. The team will let you know when you can stay and when to step out so they can do tests or treatments to help your child.</p> <h3>How Long Does ECMO Take?</h3> <p>A child may be on ECMO from a day to over a month or more. It all depends on the child's health problem.</p> <h3>What Happens After ECMO?</h3> <p>The care team will do several tests to be sure ECMO is no longer needed, then turn off the machine and remove the tubing. Your child will be eased off the ventilator as he or she adjusts to breathing without ECMO. This may take days or weeks.</p> <p>Your child might need heart medicines until the heart is fully recovered. The care team will continue to carefully watch your child and give pain medicines to keep him or her comfortable.</p> <h3>What Problems Can Happen From ECMO?</h3> <p>ECMO has significant risks. So doctors use it only when they've tried all other treatments and believe that ECMO will help.</p> <p>Risks include:</p> <ul> <li>bleeding</li> <li>bubbles or clots in the blood that may block blood vessels</li> <li>infection</li> <li>problems with the machine</li> </ul> <p>ECMO also can have some side effects, like swelling (edema), which is especially common during the first few days. The swelling usually goes away by the time ECMO is finished.</p> <h3>How Can Parents Help After ECMO?</h3> <p>Children need extra support as they recover after ECMO. Some kids may have lung problems if ECMO did the work of the lungs. Others might have some trouble walking or talking, or have a hard time with their schoolwork.</p> <p>Ask the ECMO team and your child's pediatrician about ways you can help.</p>Oxigenación por membrana extracorpórea (OMEC)La oxigenación por membrana extracorpórea (OMEC) es cuando un equipo médico muy bien formado y entrenado usa una máquina para desempeñar las funciones que normalmente desempeñan el corazón y los pulmones. https://kidshealth.org/ws/RadyChildrens/es/parents/ecmo-esp.html/96c29bf9-c571-4072-af60-7198b4909a29
CardiomyopathyCardiomyopathy is when the heart muscle becomes weak and enlarged, which makes it difficult to pump blood through the body. There’s usually no cure for the condition in children, but it can be treated.https://kidshealth.org/ws/RadyChildrens/en/parents/cardiomyopathy.html/5b4f304e-1574-4ace-9820-6a44cbada41e
Heart and Circulatory SystemThe heart and circulatory system are our body's lifeline, delivering blood to the body's tissues. Brush up on your ticker with this body basics article.https://kidshealth.org/ws/RadyChildrens/en/parents/heart.html/52398b6a-54a6-4272-a569-42ed5b12aeac
Hypoplastic Left Heart Syndrome (HLHS)Hypoplastic left heart syndrome (HLHS) is a birth defect of a baby’s heart. The left side of the heart doesn’t grow as it should, making it smaller and weaker than normal. https://kidshealth.org/ws/RadyChildrens/en/parents/hypoplastic-heart.html/3f36bb72-0bef-42bc-b6de-c0fddf263c16
Lungs and Respiratory SystemBy the time we're 70 years old, we will have taken at least 600 million breaths. All of this breathing couldn't happen without the respiratory system.https://kidshealth.org/ws/RadyChildrens/en/parents/lungs.html/6fe380c0-fe47-47a4-ba19-7e0944585a61
Meconium Aspiration Syndrome (MAS)Meconium aspiration can happen before, during, or after labor and delivery when a newborn inhales a mixture of meconium and amniotic fluid. Although it can be serious, most cases are not.https://kidshealth.org/ws/RadyChildrens/en/parents/meconium.html/ae4b1766-1f37-47f0-9627-d1ef7c5c4a7c
SepsisSepsis is a serious infection usually caused when bacteria make toxins that cause the immune system to attack the body's own organs and tissues.https://kidshealth.org/ws/RadyChildrens/en/parents/sepsis.html/ae008ddb-6b3a-494d-b020-cb6ccbbe8bcb
When Your Child Needs a Heart TransplantIf your child needs a heart transplant, you're probably feeling lots of emotions. Fortunately, many kids who undergo heart transplants go on to live normal, healthy lives.https://kidshealth.org/ws/RadyChildrens/en/parents/heart-transplant.html/0c94f853-a992-413c-b67f-2ed97ac42ec6
kh:age-allAgesOrAgeAgnostickh:clinicalDesignation-cardiothoracicSurgerykh:clinicalDesignation-pulmonologykh:clinicalDesignation-transplantkh:genre-articlekh:primaryClinicalDesignation-cardiologyHeart & Blood Vesselshttps://kidshealth.org/ws/RadyChildrens/en/parents/medical/heart/e9ef0549-4392-4778-974d-753019ce4b8bCaring for a Seriously or Chronically Ill Childhttps://kidshealth.org/ws/RadyChildrens/en/parents/system/ill/079ac5d4-e734-4351-a7f0-3bd2b4dd9d93Medical Procedureshttps://kidshealth.org/ws/RadyChildrens/en/parents/system/med-procedures/fa1ed819-e226-441d-aae1-0dfd71b557c4Lungs & Respiratory Systemhttps://kidshealth.org/ws/RadyChildrens/en/parents/medical/lungs/804af3e6-468e-4721-b805-eb88e113b3c3