ECMO | Institute Of Cardiac Sciences | Rela Institute

ECMO

Extracorporeal membrane oxygenation (ECMO) is a life support machine. People who need ECMO have a severe and life-threatening illness that stops their heart or lungs from working properly. The ECMO machine replaces the function of the heart and lungs.

ECMO is used to help people whose:

  • Lungs cannot provide enough oxygen to the body even when given extra oxygen
  • Lungs cannot get rid of carbon dioxide even with help from a mechanical ventilator
  • Heart cannot pump enough blood to the body
  • ECMO may also be used to support people with heart or lung disease that cannot be cured while they wait for an organ

ECMO & Sar-Cov-2 or Covid 19

During the recent pandemic, one treatment option that is showing promise is the use of extracorporeal membrane oxygenation (ECMO) for COVID-19 patients with severe respiratory distress. By supporting the heart and lungs, the ECMO machine stabilizes patients to allow their body more time to fight the virus. The ECMO team at Dr. Rela Institute & Medical Centre is uniquely experienced and positioned to help COVID-19 patients.

Even though there’s more to learn about how COVID-19 affects the body, doctors know that it primarily affects the lungs. In certain cases, the virus can entirely overwhelm the lungs and, in turn, negatively affect the heart.

Because all five lobes of the lung are damaged, they can’t properly exchange oxygen and carbon dioxide. As carbon dioxide levels in the body increase, so does respiratory rate, as the brain tells the body to breathe more to rid itself of this carbon dioxide. However, since the lungs are damaged and are unable to so, this carbon dioxide remains in the blood and turns to acid.

The body doesn’t work well in an acidic environment. The lungs get stiffer and the pressure to push blood through the lungs goes up, known as pulmonary hypertension. This puts strain on the heart and causes it to fail. When the body fails to this degree, that is when ECMO can help.

PROCEDURE DETAILS

In a general scenario when there is a need for heart and lung transplant, the ECMO machine is connected to a patient through plastic tubes (cannula). The tubes are placed in large veins and arteries in the legs, neck or chest. The procedure by which doctors places these tubes in a patient is called cannulation. The ECMO machine pumps blood from the patient’s body to an artificial lung (oxygenator) that adds oxygen to it and removes carbon dioxide. Thus, it replaces the function of the person’s own lungs. The ECMO machine then sends the blood back to the patient via a pump with the same force as the heart, replacing its function.

Procedural Details in Covid -19 Cases

When a COVID-19 patient is referred to an ECMO team, a right ventricular support device (RVAD) and oxygenator within the ECMO machine is used. The RVAD is placed inside the patient through the tube that goes into the patient’s neck, down through the right atrium and right ventricle of the heart and into the pulmonary artery. This allows for blood to be taken out of the right atrium and sent to the ECMO machine. There, it’s filtered, temperature-modulated and oxygenated, and the carbon dioxide is removed. This blood then enters the body through a tube placed into the pulmonary artery.

This ECMO process supports patients’ bodies and allows them extra time to attack and overcome the virus. This extra time that they are allotted is often necessary for patients in such extremes, with the average COVID-19 patient staying on ECMO for 10–12 days.

Certain patients with an aggressive form of COVID-19 are susceptible to a “cytokine storm,” which can cause a severe inflammatory response and multiple organ failure. This happens when a patient’s immune system malfunctions and attacks its own cells. ECMO has been shown to reduce the chances of a cytokine storm.

ECMO is taken off when the patient shows signs of improvement and lung/heart can function independently. Once off ECMO, they then remain isolated while recovering in the cardiovascular intensive care unit.

WHY RIMC

RIMC is one of the leading hospitals in Chennai with rehabilitation on ECMO, with the ability to take on high-risk patients. We can support you on ECMO if your heart and lungs need to recover, or until a transplant becomes available.

With new possibilities of treating Covid- 19 with ECMO, RIMC is proactively engaging in any possible life-saving measures to ensure that patients are treated with positive results. Always supporting life!

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