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Extracorporeal membrane oxygenation
ECMO; Heart-lung bypass - infants; Bypass - infants; Neonatal hypoxia - ECMO; PPHN - ECMO; Meconium aspiration - ECMO; MAS - ECMO
Information
Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream of a very ill baby. This system provides heart-lung bypass support outside of the baby's body. It may help support a child who is awaiting a heart or lung transplant.
WHY IS ECMO USED?
ECMO is used in infants who are sick due to breathing or heart problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal.
The most common conditions that may require ECMO are:
- Congenital diaphragmatic hernia (CDH)
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Birth defects of the heart
Birth defects of the heart
Cyanotic heart disease refers to a group of many different heart defects that are present at birth (congenital). They result in a low blood oxygen l...
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Meconium aspiration syndrome (
MAS
)
MAS
Meconium aspiration syndrome (MAS) refers to breathing problems that a newborn baby may have when: There are no other causes, andThe baby has passed ...
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Severe
pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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- Severe high blood pressure in the arteries of the lungs (PPHN)
It may also be used during the recovery period after heart surgery.
HOW IS A BABY PLACED ON ECMO?
Starting ECMO requires a large team of caregivers to stabilize the baby, as well as the careful set-up and priming of the ECMO pump with fluid and blood. Surgery is performed to attach the ECMO pump to the baby through catheters that are placed into large blood vessels in the baby's neck or groin.
WHAT ARE THE RISKS OF ECMO?
Because babies who are considered for ECMO are already very sick, they are at high risk for long-term problems, including death. Once the baby is placed on ECMO, additional risks include:
- Bleeding
- Blood clot formation
- Infection
- Transfusion problems
Rarely, the pump can have mechanical problems (tube breaks, pump stops), which can harm the baby.
However, most babies who need ECMO would probably die if it were not used.
References
Carlo WA, Ambalavanan N. Respiratory tract disorders. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 101.
Crowley MA, Stork EK. Therapy for cardiorespiratory failure in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine . 10th ed. Philadelphia, PA; Elsevier; 2015:chap 78.
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ECMO - illustration
ECMO stands for Extra Corporeal Membrane Oxygenation. ECMO is used in infants who are extremely ill due to breathing or heart problems. The ECMO machine circulates blood through an artificial lung back into the bloodstream. This provides adequate oxygen to the baby while allowing time for the lungs and heart to "rest" or heal.
ECMO
illustration
-
ECMO - illustration
ECMO stands for Extra Corporeal Membrane Oxygenation. ECMO is used in infants who are extremely ill due to breathing or heart problems. The ECMO machine circulates blood through an artificial lung back into the bloodstream. This provides adequate oxygen to the baby while allowing time for the lungs and heart to "rest" or heal.
ECMO
illustration
Review Date: 2/10/2016
Reviewed By: Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
