ECMO

The ECMO is a machine that mimics the functions of the heart and lungs. It is predominantly used during open-heart surgeries at Max hospital, India, where our doctors bypass the function of the organs to the machine while repairing it. The ECMO machine helps in pumping and oxygenating the blood outside the body, allowing the lungs and the heart to rest. The success rates of the ECMO procedure at Max Hospital, India, have been remarkable and have proven to be beneficial in saving the lives of hundreds of patients. The facility has the best panel of specialists and state of the art technology to ensure the best treatment for their patients. There are two types of ECMO, namely

  1. VA ECMO: This is connected to both a vein and an artery. It is used when there are problems with both the lungs and the heart.
  2. VV ECMO: This is connected with one or many veins near the heart. It is used when only the lungs are affected.
ECMO is used in patients recovering from lung failure, heart failure, or heart surgery. It is also used as a bridge when doctors want to assess the state of other organs, and when patients wait for a lung transplant.

Conditions that mandate the use of ECMO

  1. Pneumonia – bacterial infections of the lungs
  2. Sepsis – a bacterial infection of the blood
  3. Congenital hernia of the diaphragm
  4. Congenital heart conditions in children
  5. End-stage cardiac or respiratory failures
  6. Meconium Aspiration syndrome

Symptoms

Patients who require ECMO therapy have the following symptoms:
  1. Shortness of breath
  2. Inability to breath during sleep – sleep problems
  3. Swelling in the legs and abdomen
  4. Chronic cough and wheezing
  5. Confusion and altered mental status
  6. Rapid and fast heart rate
  7. Lack of appetite

Medical Tests and Diagnosis

Doctors perform a series of diagnostic tests before the ECMO procedure to ascertain if the problem is with the heart or the lungs.
  1. Echocardiogram: Uses sound waves to access the functioning of the heart
  2. Electrocardiogram: This is a test to monitor the electrical activities of the heart
  3. USG Head: This is performed on young infants to rule out bleeding in the brain. The ECMO is not used in case of severe bleeding in the brain

Pre-procedure preparations

Connecting the patient to the ECMO device is a surgical procedure and is performed in the ICU. The patient is sedated and is administered anti-coagulant to minimize clotting of the blood. After inserting the ECMO catheters in the blood vessels, X-rays are taken to ensure that the tubes are in the right place. The patient is also connected to a ventilator to allow the lungs to heal. The patient is closely monitored by a team of therapists and nurses, along with the surgical team. The nasogastric tube is also inserted to help the patient with supplemental nutrition.

Post-procedure precautions

Removing the ECMO tubes and discontinuing the patient from the machine is also a surgical procedure. Multiple tests are performed before discontinuing. It is to ensure that the heart and lungs are ready to function on their own. The blood vessels will be repaired after removing the ECMO.  

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