What are the four types of ECMO?

Different types of ECMO
  • V-A ECMO. V-A, or veno-arterial ECMO, supports both heart and lung function. …
  • V-V ECMO. V-V or veno-venous ECMO, supports lung function primarily. …
  • Variation in V-V ECMO cannulae sites. …
  • Central cannulation for V-A ECMO.

What’s the difference between VV and VA ECMO?

VA ECMO provides both respiratory and hemodynamic support; the ECMO circuit here is connected in parallel to the heart and lungs, while in VV ECMO the circuit is connected in series to the heart and lungs. During VA ECMO, blood will bypass both the heart and the lungs.

Is VV or VA ECMO worse?

Compared to VV ECMO, VA ECMO was independently associated with an increased risk of neurologic injury, stroke and bleeding in neonatal and pediatric studies (15–17). Therefore, VV ECMO has become the more commonly used for respiratory failure refractory in pediatric critical care (18).

What is ECMO technique?

Overview. In extracorporeal membrane oxygenation (ECMO), blood is pumped outside of your body to a heart-lung machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body.

What is VA ECMO used for?

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange for acute cardiorespiratory failure.

What is the most common complication of ECMO?

Bleeding is the most common complication (30 to 40 percent) of ECMO. Thromboembolism and cannula complications are rare (<5 percent).

What is a VV ECMO?

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a temporary mechanical assistance device that allows for prolonged cardiopulmonary support. A modification of the cardiopulmonary bypass machine, it is instituted in patients with life-threatening respiratory failure (predicted mortality 80 percent).

Does VV ECMO support heart?

Venoarterial (VA) ECMO can be used for heart and lung support, while venovenous (VV) ECMO is used for lung support only. The ECMO team will decide which type will help your loved one the most, based on his or her specific illness.

How does veno venous ECMO work?

The VV ECMO circuit drains venous blood, oxygenate the blood, and pump the blood back into the same venous compartment. That means that the VV ECMO circuit is totally separated from the patients’ cardiac output (CO). With no CO the pump flow in the ECMO circuit will result in 100% recirculation.

What type of ECMO can be performed using a single catheter?

While VV-ECMO circuits usually include the cannulation of two vessels (double cannulation) in the classic configuration, the use of a single cannula is now possible for VV-ECMO support.

Is the heart stopped during ECMO?

During ECMO treatment, the heart continues to beat, but its work is made easier because the ECMO machine does much of the pumping. The goal of ECMO is to ensure that the body has enough blood flow and oxygen by temporarily managing the workload of the heart and lungs.

How long can a person be on a ECMO machine?

ECMO treatment may last only a few hours or days, but in some cases, ECMO might continue for weeks. Before the COVID-19 pandemic, the average ECMO treatment lasted about 10 days, according to Glenn Whitman, M.D., director of the cardiovascular surgical intensive care unit.

What percentage of patients survive ECMO?

What is the survival rate for ECMO patients? I believe the most recent estimates for the survival rate for ECMO in the United States, for all types of COVID ECMO, is a little above 50%. Centers that do a lot of ECMO, however, may have survival rates above 70%.

Do people come off ECMO?

Once at “low flow,” or idling, the patient can be taken off ECMO for a “wean,” during which the patient is assessed to determine whether he/she is ready to come off ECMO. If the patient appears to do well during the trial off ECMO, then the surgeon will remove the cannulas.

How much is ECMO per day?

Various reports estimate these as ranging between US dol- lars (USD) 20,000 and 40,000 per day. 5,6 Hospitalizations for PCS-ECMO are estimated at approximately USD 200,000 to 500,000 and where it is used as a bridge to LT, the median hospital charges are increased by as much as 50%.

Do you do CPR on an ECMO patient?

Should you do chest compressions in a VV ECMO cardiac arrest? YES! In a VV ECMO cardiac arrest cardiac compressions must be commenced according to the normal ACLS pathway. With good quality CPR enough venous return can be produced for VV ECMO to continue at low flows.

What is the quality of life after ECMO?

Health-related quality of life deficits persist in the long-term for ECMO patients, indicating the need for continued patient follow-up. Survival in ECMO patients at 5 years is favourable for patients who endure the initial 30 days post-VA- or VV-ECMO. Survivors have little regret with the decision to be put on ECMO.

What is the longest someone has been on ECMO?

Hamm was on ECMO for 147 days, a remarkably long time. Hamm was on ECMO for 147 days, a remarkably long time. (Photography: Steve Wood)Ricky Hamm is no stranger to UAB Hospital.

What does it feel like to be on ECMO?

You shouldn’t feel serious pain or discomfort when the tubes are put in place or while the ECMO machine does its work. You’ll be getting medicine to make you sleepy while you’re on ECMO. But you may be awake enough to interact and talk, as long as you’re not on a ventilator.

How long can a baby live on ECMO?

ECMO is usually intended for use from 5 to 28 days. This depends on the severity of your child’s condition. The decision to discontinue ECMO is made when careful evaluation of your child’s lung and heart function has been made.

Who is not an ECMO candidate?

Contraindications to ECMO

High pressure ventilation or high FIO2 requirements for more than 7 days. Limited vascular access. Inability to accept blood products. Severe coagulopathy.

What makes someone an ECMO candidate?

For instance, a patient whose lungs do not provide adequate oxygen to the body, even when given oxygen, may be a candidate for ECMO.

How long can you stay on VV ECMO?

ECMO is generally continued until the underlying cardiac or lung problem is improved or resolved. The typical course is around five days, but in some cases, ECMO support has been continued for up to 25 to 30 days.