ECMO stands for extracorporeal membrane oxygenation. In some patients in intensive care, lung and/or heart function is so severely impaired that a ventilator and cardiac support medication are insufficient, and ECMO is required. This impairment may result from, amongst other things, severe heart failure, serious bacterial or viral infections, lung problems following surgery, or pneumonia caused by aspiration.
The ECMO machine then takes over the function of the lungs or the heart. The system is therefore also known as a heart-lung machine. Two types can be used, depending on which organ requires more support: VA-ECMO and VV-ECMO.
VA-ECMO
Venoarterial ECMO, or VA-ECMO, is used in cases of heart failure with or without lung failure.
The blood flows from a large vein through a cannula (hollow tube) via a pump to the artificial lung, where oxygen is administered. The oxygen-rich blood is then returned to the body via another cannula, into a large artery. In this way, the ECMO machine takes over the functions of the lungs and the heart. This gives those organs time to rest and, with the help of medication, to recover.
VV-ECMO
Venovenous ECMO, or VV-ECMO, is used when the lungs are unable to absorb sufficient oxygen or expel carbon dioxide, despite maximum ventilation. With this type of ECMO, too, blood is pumped from a large vein through a cannula to an artificial lung, where it is oxygenated. Unlike with VA-ECMO, the machine then returns the blood to a large vein. The patient’s heart must therefore be functioning normally to pump the oxygen-rich blood through the lungs and the rest of the body. The machine takes over the function of the lungs until they have recovered sufficiently to provide enough oxygen on their own.
Want to know more?
- See the leaflet on ECMO or the heart-lung machine (258.65 KB) "pdf" (in Dutch)
- Read the article on ECMO in our journal UZ Letters (in Dutch)