A Lifesaving Treatment Option for Patients with Acute Respiratory Distress Syndrome or Cardiogenic Shock
Extracorporeal membrane oxygenation (ECMO) provides prolonged respiratory and cardiac support to adult patients whose lungs and heart are too diseased or damaged to function normally on their own. Jefferson's Dr. Nicholas Cavarocchi is one of a few doctors in the U.S. experienced in ECMO.
An ECMO machine is similar to a heart-lung machine. It consists of the:
- Venous cannula – Catheter is inserted into a vein to drain the blue blood (without oxygen)
- Arterial cannula – Catheter is inserted into a vein for red blood return (with oxygen)
- Pump – Can be adjusted to achieve the desired blood flow
- Oxygenator – Pumps the blood through an artificial lung, which helps circulate the blood through the body
- Water heater – Blood is warmed to body temperature and pumped throughout the body
How Do You Contact Jefferson for ECMO Assistance?
Call the Jefferson Transfer Center at 1-800-JEFF-121 (1-800-533-3121), and say, "I would like an ECMO consult" or "I would like to transfer a patient for ECMO."
When your loved one is placed on ECMO, blood will flow through the ECMO machine tubing where it receives oxygen from the machine's artificial lung. There are two types of ECMO:
- In veno-arterial (VA) ECMO, one cannula will be placed in a large vein and another in an artery. VA is used when there are problems with the heart, lungs or both.
- In veno-venous (VV) ECMO, a double tube is placed in a large vein, removing unoxygenated (blue) blood and returning oxygenated (red) blood. VV is used when there are lung problems only.
These cannula are connected to a specialized ECMO machine, which avoids the serious side effects of bleeding and hemolysis. Our intensive care staff closely monitors each patient during the procedure to ensure that they are stable and comfortable. Highly trained registered nurses, physician assistants, a perfusionist, a respiratory therapist and certified critical care nurses follow standardized protocols to support the care.
Jefferson uses highly advanced pumps and oxygenators specially designed and proven to minimize potential complications.
As your loved one's health improves, less support will be needed as the heart and/or lungs are able to function on their own. On average, the patient is on ECMO for a week to 10 days. Respiratory patients may be on ECMO for longer. Weaning from a breathing machine mostly occurs after removal of ECMO.
Respiratory diseases and conditions potentially treatable by ECMO are:
- Acute respiratory distress syndrome (ARDS)
- H1N1 Influenza A respiratory failure
- Aspiration pneumonia
- Sepsis-related ARDS
- Pneumonia (viral, bacterial, atypical)
- Pancreatitis with SIRS
- Burns (smoke inhalation)
- Pulmonary embolism
- Tricyclic antidepressant overdose
- Rescue therapy for a failed lung transplant (Tx) or as a bridge to Lung Tx
Cardiac diseases supported by ECMO can include:
- Cardiogenic shock any cause except sepsis
- Acute myocardial infarction
- Refractory arrhythmia
- Post-partum cardiomyopathy
- Pulmonary embolus
- Post-cardiotomy failure
- Acute or chronic heart failure
- Post-transplant organ failure
- Hypothermic arrest
- Bridge to VAD or transplant
- Superior outcomes. Our adult ECMO program survival rates far exceed national reported rates. Patients are placed on ECMO earlier than usual, which improves their chances of either being successfully weaned from ECMO or having surgery with fewer complications.
- State-of-the-art technology and newly renovated CVICU. Jefferson uses highly advanced pumps and oxygenators specially designed and proven to minimize potential complications. The newly renovated CVICU provides all of the latest in cardiac care and technology.
- Dedicated adult ECMO team. Under Dr. Cavarocchi's leadership, our well-trained adult ECMO team of ICU physicians, physician assistants, nurses, perfusionists, respiratory therapists and certified critical care transport nurses have achieved significant expertise.
- Mobile ECMO transport service when necessary.