Extracorporeal Membrane Oxyge... Health Article

Definition

Extracorporeal membrane oxygenation (ECMO) is a procedure that uses an artificial heart-lung machine to take over the work of the lungs (and sometimes the heart). ECMO is used most often in newborns and young children, but it also can be used as a last resort for adults whose heart or lungs are failing.

Purpose

In newborns, ECMO is used to support or replace an infant's undeveloped or failing lungs by providing oxygen and removing carbon dioxide waste products so the lungs can rest. Infants who need ECMO may include those with the following problems:

• Meconium aspiration syndrome: Breathing in of a newborn's first stool by a fetus or newborn, which can block air passages and interfere with lung expansion.
• Persistent pulmonary hypertension: A disorder in which the blood pressure in the arteries supplying the lungs is abnormally high.
• Respiratory distress syndrome: A lung disorder usually of premature infants that causes increasing difficulty in breathing, leading to a life-threatening deficiency of oxygen in the blood.
• Congenital diaphragmatic hernia: The profusion of part of the stomach and/or intestines through an opening in the diaphragm.
• Pneumonia
• Blood poisoning
• Inborn errors of metabolism: Some genetic diseases.

ECMO is also used to support a child's damaged, infected, or failing lungs for a few hours to allow treatment or healing. It is effective for those children with severe, but reversible, heart or lung problems who have not responded to treatment with a ventilator, drugs, or extra oxygen. Children who need ECMO usually have one of the following problems:

• immature or underdeveloped lungs
• heart failure
• pneumonia
• respiratory failure caused by trauma or severe infection
• status asthmaticus (severe asthma attack)

The ECMO procedure can help a patient's lungs and heart rest and recover, but it will not cure the underlying disease. Any patient who requires ECMO is seriously ill and will likely die without the treatment. Because there is some risk involved, this method is used only when other means of support have failed.