ECMO

Pediatric Extracorporeal Membrane Oxygenation (ECMO) – an advanced technology that functions as a temporary replacement for a child’s heart and lungs before and after cardiovascular surgery, is available at Children’s Hospital of Michigan and is one of only a few hospitals in Michigan to provide this level of advanced care to children. 

ECMO is a form of external life support where artificial circulation is established by cannulas and tubing carrying venous blood from the patient through a gas exchange device (oxygenator) and then pumped into the patient. The oxygenated blood is returned to the patient via the venous side (veno-venous ECMO) to provide lung support when the patient is in severe respiratory failure when no major cardiac dysfunction exists. Blood is returned to the arterial side (veno-arterial ECMO) to provide both heart and lung support. This configuration is used when the patient has severe cardiac failure and usually associated with respiratory failure. 

Patients who are hypoxemic and/or hypercarbic despite maximal conventional ventilator support or who are in reversible cardiogenic shock may be considered for ECMO support. 

Indications for Ecmo 

V-V ECMO 

  • Severe viral or bacterial pneumonia
  • Pediatric Acute Respiratory Distress Syndrome (PARDS)
  • Pulmonary contusions after major trauma

Rarer indications: Alveolar proteinosis, smoke inhalation, status asthmaticus, airway obstruction, aspiration syndromes.

V-A ECMO

  • Cardiogenic shock after acute myocardial infarction
  • Cardiogenic shock after open heart surgery
  • Drug overdose with cardiac failure
  • Acute Viral Myocarditis

Rarer indications: Acute pulmonary embolism, Cardiac or major blood vessel trauma, massive hemoptysis, pulmonary trauma, acute anaphylaxis, post-partum cardiomyopathy, sepsis, profound hypothermia.


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