Artificial lung technology, also known as ECMO or extracorporeal membrane oxygenation pumps blood through an artificial lung device and back into the body of the patient. Used in both adults and children, artificial lung technology provides long term management of heart or lung failure while the patient awaits a transplant or heals after surgery.
ECMO is ideal for patients who have compromised cardiovascular health, a high mortality rate, or would not be able to maintain their current physical status if placed on traditional mechanical ventilation. ECMO may be used while the patient is awake, alert and ambulatory which greatly reduces the risk for complications related to immobility and ventilator use. Patients with acute respiratory distress syndrome (ARDS) who do not have multi-system or non-pulmonary organ failure and cannot maintain normal mechanical ventilation are among qualifying candidates for use. There are a variety of criteria providers may use to determine if a patient qualifies for ECMO.
ECMO may be used in one of two ways: venovenous (VV) and venoarterial (VA) methods.
Venoarterial ECMO utilizes blood from a central vein or the right atrium of the heart and pumps it past an oxygenator worn outside the body. The blood then returns under pressure to the aorta to be pumped out to the body. This method helps support the amount of blood that is pumped by the heart (cardiac output).
Venovenous ECMO takes deoxygenated blood from a large vein, passing it through the oxygenation process and returns it to the body through another large vein. This form does not support cardiac output of the heart. VV ECMO also allows for the removal of carbon dioxide through the artificial lung unit and doesn’t just add oxygenated blood alone.
Patients receiving ECMO will have a large catheters (tubes) placed in the body to remove and replace the blood volume after gas exchange. Because of the risk of blood clots, patients will be given anticoagulant drugs (blood thinners) to reduce the risk of clot formation and complications.
ECMO has been used for decades in newborns and children with lung failure, pneumonia, meconium aspiration syndrome and other conditions and is used less often in adult patients because so few are candidates for it but shows great promise for the treatment of many heart and lung problems and allows new organs to heal after transplant.