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Benefits and Risks

Benefits of Extra Corporeal Membrane Oxygenation (ECMO)

The main advantage of ECMO is that it can maintain the supply of oxygen to the body while resting the lungs.  As well as an oxygenator (or artificial lung) the ECMO circuit relies on a motor to pump the blood around.  This means that the pumping ability of the ECMO machine can also provide support for reversible heart disorders when required.

Traditionally patients with lung injury are treated on a ventilator.  A ventilator pushes oxygen into the patient’s lungs.  If the lungs are badly damaged, high pressures and high levels of oxygen are required to maintain the oxygen levels in the blood.  High pressure and high oxygen levels in themselves cause lung damage, so the injured lung becomes more damaged and the pressure needs to be increased further which causes yet more damage.  ECMO breaks this cycle and allows the lungs to be rested while the body heals the damage.  This is similar to the way that a plaster cast supports a broken arm whilst the bone repairs.  Remember: ECMO does little to heal the underlying condition, it only provides support for healing to occur.


Risks of ECMO

The main risk during ECMO treatment is bleeding.  When blood is removed from the body and pumped through plastic tubing it tries to clot.  To prevent this, a blood-thinning drug called Heparin is used.  Unfortunately this may cause bleeding.  Although bleeding can occur in any part of the body, it is most serious when it occurs in the brain and often results in death.  The risk of bleeding is increased if a surgical operation is required as part of the treatment whilst on ECMO.

The VA ECMO surgical procedure sometimes involves tying off the carotid artery (usually only carried out in newborn babies).  The carotid artery is one of the blood vessels that supplies blood to the brain.  This does not usually cause any complications because other blood vessels take over and carry blood to the brain.

Anybody receiving ECMO will require transfusions of blood and clotting factors.  As with any blood transfusion, there is always a (very low) risk of a blood reaction, as well as a risk of transmission of blood borne infections such as HIV.  The blood used from the blood bank is screened for infections.  However, there remains a small risk that such a disease could be acquired.