ECMO or Extracorporeal Membrane Oxygenation is like the heart-lung by-pass machine used in open-heart surgery. It oxygenates blood of the patient outside the body. Thus, enabling the heart and lungs to relax. When connected to an ECMO machine, blood flows through the tubing to an artificial lung in the machine. This helps add oxygen and takes out carbon dioxide. In the procedure, blood is warmed to your body temperature and pumped back into your body. This process allows the blood to ‘bypass’ the heart and lungs, thereby, enabling these organs to rest and heal.
The ECMO machine used in top hospitals in Hyderabad stabilizes patients to allow their body more time to fight the virus by supporting the heart and lungs. ECMO is used in critical care conditions such as for COVID-19, ARDS and other infections. During the recent pandemic situation, one treatment option that is showing good results is the use of ECMO treatment for covid patients with severe respiratory distress.
Types of ECMO
There are two types of ECMO:-
Venoarterial ECMO –
In this type of ECMO, blood is drawn out of a large vein and is returned it into a large artery. Thus, allowing the oxygen-rich blood to circulate through your body. It happens even if the heart is too weak to pump blood. Therefore, two cannulas will be placed in either the neck or the groins.
Venovenous ECMO –
This type of ECMO provides lung support only. It suggests that the heart of the patient still functions well enough to meet the needs of the body. In this case, two cannulas are placed into the veins in the places near or inside the heart. This will allow blood to return to your body in one specific place. Thereby, creating the need for only one entry site instead of two. Blood returns to the body and the patient’s heart pumps blood throughout the body.
This is known as one of the best solutions employed in the critical care unit of hospitals to heal heart and lungs. It is used for extremely ill covid patients. ECMO treatment does not treat a disease but assists your body temporarily by allowing the heart and the lungs to rest.
Some of the conditions that require ECMO treatment are acute myocardial infarction, Decompensated cardiomyopathy, Sepsis, Severe hypothermia, acute respiratory distress syndrome and Coronavirus disease 2019, and much more.
How is ECMO Useful in COVID-19?
Due to the ongoing COVID-19, patients struggle to breathe due to the health complications. This is the reason doctors use EMCO procedure as one of the treatment procedures. However, ECMO is used as a last resort when patients do not respond to any other treatment.
What is ECMO Treatment?
ECMO is employed to help a patient when all other options to supply oxygen to the body run dry. As mentioned, the ECMO machine is connected to the patient through a set of plastic tubes. The ECMO procedure steps of connecting the tubes to the vascular system of a patient is called cannulation. With the help of this method, blood is pumped into the oxygenator. And, replacing the carbon dioxide with oxygen, and then pumped back into the patient’s body. The setting of the machine is handled by a trained nurse or a respiratory specialist who can adjust the machine to provide the appropriate support to the heart and the lungs.
How Does ECMO Work?
When connected to the ECMO, the patient is closely monitored. It helps to check for heart rate, blood pressure, blood oxygen levels, and carbon dioxide levels. Additionally, a patient on ECMO is connected to the ventilator and the endotracheal tube. The patient feels almost no pain and the blood thinners are also employed to prevent clotting when outside the body. Depending on the severity of the disease, a patient may continue to be on ECMO from a few days to several weeks. It is possible that in some of the cases, patients may not recover from the severity despite ECMO. However, it helps to improve the survival of the patients. There are a few long term effects of ECMO treatment.
ECMO Side Effects
You may notice some of the ECMO side effects such as:-
- Bleeding: ECMO can result in bleeding in different parts of the body. And, it can even be serious in cases when the bleeding is not identified and contained.
- Infection: Cannulation increases the chances of infection in a patient who is already battling a previous infection. It is possible that the infection can reach the lungs. But, it can be successfully treated with an antibiotic, thus, preventing organ damage.
- Kidney failure: The kidneys may also undergo severe damage called acute renal failure due to the lack of enough blood circulating to the kidney. The patient may also be connected to a dialysis machine to support the functioning of the kidneys.
- Stroke: If certain parts of the brain do not receive oxygen as much as the rest it may result in strokes and permanent damage to the brain. Thus, leading to further complications, such as paralysis and loss of movement of certain body parts.
It can be concluded that ECMO is a life-sustaining treatment and not a cure. This treatment procedure is used primarily on patients who require oxygen support. It helps support a patient’s heart and the lungs. This is done by oxygenating the blood entering the machine and removing the carbon dioxide from the blood. It has played an effective treatment method for the COVID patients as well.