1. Extra Corporeal Membrane Oxygenation
ECMO
Extra Corporeal Membrane Oxygenation

2. Extracorporeal membrane oxygenation
ECMO

3. ECMO
Extracorporeal membrane oxygenation (ECMO) is a special procedure that uses an artificial heart-lung machine to take over the work of the lungs (and sometimes also 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.

5. ECMO
Indications…
ECMO is used to treat respiratory or cardiac failure that is unresponsive to all other measures but is considered to have a reversible cause.

6. ECMO For example… meconium aspiration syndrome
persistent pulmonary hypertension
respiratory distress syndrome
congenital diaphragmatic hernia,
pneumonia
Heart failure

7. ECMO
Types:Venoarterial (V-A) ECMO
Supports the heart and lungs.

8. ECMO
Venovenous (V-V) ECMO:
supports the lungs only

11. ECMO
Goals
Improvement in Q (cardiac output), although no more than 50% of the workload
Gas exchange
Oxygenation
CO2 is titrated INTO the circuit to compensate for such efficent removal!

12. ECMO Selection Criteria Mech ventilation for less than 14 days
Gestational age >33 weeks
Weight .1.8 kg
Reversible disease process
Failure of maximal medical management
Predicted mortality >80%

13. ECMO Exclusion criteria: Major intracranial hemmorage
Lethal malformation
Severe neurologic injury
Uncontrolable coagulopathy
Syndrome with poor prognosis

14. ECMO Clinical indications Oxygen Index (OI) >40
PaO2 < 40 mmHg while on 100% FIO2 X 4 hours
Intractable metabolic acidosis
Intractable shock
Progressive and intractable pulmonary or cardiac failure

18. ECMO
References:

19. 2247 Specialties Closing remarks:
ECMO is the height of clinical skill and training, and even if you choose not to participate in ECMO, be a practitioner worthy of this level of skill….don’t stop learning!