The term ECMO means Extracorporeal Membrane Oxygenation. The ECMO treatment is similar to the heart-lung by-pass used in open-heart surgery.
- The ECMO machine, which is connected to a patient through plastic tubes, pumps and oxygenates a patient’s blood. The oxygenation process outside the body allows the heart and lungs to rest.
- Once connected to an ECMO, blood flows through an artificial lung in the machine. The machine adds oxygen and takes out carbon dioxide. After this, blood is pumped back into the body with the same force as the heart after it is warmed up to the body temperature.
- Some of the conditions and illnesses for which ECMO is used include asthma, postoperative cardiac surge, aspiration, pneumonia.
What is a ventilator?
A ventilator is a life support treatment that is helpful when a person is unable to breathe independently.
- It is connected to the patient through tubes in the mouth or the neck. There is also non-invasive ventilation delivered through a mask.
- Depending on the medical condition, it can be referred to as a respirator or breathing machine. A ventilator can support or completely control breathing for the short or long term.
When are the two procedures advised?
- The ECMO treatment has different reasons to be advised for a patient. The most basic reason is that the patient either requires a heart or lung transplant. The other reason could be the possibility of such injury that hinders the normal flow of blood in the body. Also, treatment is required when the lungs cannot get rid of carbon dioxide, even with help of a ventilator.
- On the other hand, mechanical ventilation is advised when the patient has low oxygen levels. It is also advised when there is severe shortness of breath from an infection, like in case of sepsis, pneumonia, or heart failure.
Is ECMO preferred over ventilator?
ECMO treatment is used for patients in life-threatening situations but in reversible conditions. Also, ECMO does not cure the heart or lungs. This treatment gives a chance to the patient to survive while these organs are inefficient. In addition, ECMO is highly invasive and should only be used for patients with severe respiratory failure; or who failed to respond to conventional therapies.
In life-threatening cases, a ventilator is insufficient to keep up the blood oxygen level. This is where ECMO plays a major role. Patients on ECMO are already connected to a ventilator using a tube placed in the nose or mouth and down into the windpipe. In about 20% of cases, patients do not improve even after ECMO treatment. Mostly it is the last remaining effort done to save a life.
ECMO treatment is very costly and resource-intensive, and some patients need to be on it for weeks.
There are also various risks involved while being on ECMO like:
- Internal bleeding due to thinning of blood
- Kidney failure (acute renal failure)
- High risk of infection
- Stroke
- Leg damage
Conclusion
ECMO is only a “life-sustaining treatment,” and it does not cure or treat the disease. A decision about whether there is a benefit to continuing ECMO can be hard. The decision mainly depends on the healthcare providers and the patient (or relatives).