Rahul, a 35 year old engineer, was suffering from fever and cough. He was visiting his family physician for the last 5 days because his fever was not receding despite medication. He became very weak and was struggling to breathe. He was rushed to the nearest hospital, where the physician placed him on an artificial breathing device. However, Rahul was not receiving sufficient oxygen since he was suffering from an “ARDS” (Acute Respiratory Distress Syndrome). This acute disease led to the failure of kidney, liver and lungs. The outcome was poor, so doctors recommended a new therapy called ECMO for Rahul. This therapy proved to be beneficial for him and within few minutes, his organs started recovering. The machine was attached for almost 14 days and he was released from the hospital in a healthy state.
How does ECMO work?
ECMO (extracorporeal membrane oxygenation) is a complex system, similar to the heart-lung bypass machine used in open heart surgery. When a patient is connected to ECMO, blood flows through tubing to an artificial lung in the machine, which adds oxygen and takes out carbon dioxide. Thereafter, the blood is warmed as per the body temperature and pumped back in the body.
How did ECMO help Rahul Recover?
It pumped and oxygenated Rahul’s impure blood outside the body, allowing the heart and lungs to rest. The impure blood then went through the ECMO machine, which purified it and sent it back to the body through complex system of channels.
When is ECMO used?
There are two types of ECMO- VA ECMO is connected both to a vein and an artery and is used when there are problems with both heart and lungs. The VV-ECMO is connected to one or more veins, usually near the heart and is used when the problem is only in the lungs. The machine is primarily used for:
- Patients recovering from heart failure, or lung failure or heart surgery.
- As a bridge option to further treatment, i.e. when doctors want to assess the state of other organs such as the kidneys or brain before performing heart or lung surgery.
- Providing support during high-risk procedures in the cardiac catheterization lab after massive heart attack.
- As a bridge to a heart assist device, such as left ventricular assist device (LVAD).
- As a bridge for patients awaiting lung transplant. The ECMO helps keep tissues well oxygenated, which makes the patient a better candidate for transplant.
- Severe lung failure following Swine Flu infection (H1N1)
- Severe lung failure following Dengue fever.
Results of ECMO
Studies have shown upto 70% success rate with ECMO therapy, however in most of the cases the results depend on how serious is the lung injury at the time of starting this therapy. There is 70% success rate with ECMO therapy, however, in most of the cases, the results depend on how serious is the lung injury at the time of starting this therapy.