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    Extracorporeal membrane oxygenation

    ECMO; Heart-lung bypass - infants; Bypass - infants

    Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream of a very ill baby. This system provides heart-lung bypass support outside of the baby’s body. It may help support a very ill children who are awaiting a heart or lung transplant. More research is needed to understand how well it works.

    WHY IS ECMO USED?

    ECMO is used in infants who are extremely ill due to breathing or heart problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal.

    The most common conditions that may require ECMO are:

    • Congenital diaphragmatic hernia (CDH)
    • Heart malformations
    • Meconium aspiration syndrome (MAS)
    • Severe pneumonia
    • Severe air leak problems
    • Severe pulmonary hypertension

    It may also be used during the recovery period after heart surgery.

    HOW IS A BABY PLACED ON ECMO?

    Starting ECMO requires a large team of caregivers to stabilize the baby, as well as the careful set-up and priming of the ECMO pump with fluid and blood. Surgery is performed to attach the ECMO pump to the baby through catheters that are placed into large blood vessels in the baby's neck or groin.

    WHAT ARE THE RISKS OF ECMO?

    Because babies who are considered for ECMO are very ill, they are already at high risk for long-term problems, including death. Once the baby is placed on ECMO, additional risks include:

    • Bleeding
    • Blood clot formation
    • Infection
    • Transfusion problems

    Rarely, the pump can have mechanical problems (tube breaks, pump stops), which can harm the baby.

    However, most babies who need ECMO would probably die if it were not used.

    References

    Jobe AH. The respiratory system. In: Martin R, Fanaroff A, Walsh M, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2006:chap 42.

    Roosevelt GE. Acute Inflammatory Upper Airway Obstruction (Croup, Epiglottitis, Laryngitis, and Bacterial Tracheitis). In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 377.

    Carlo WA. Respiratory Tract Disorders. In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 95.

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    • ECMO

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      • ECMO

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      A Closer Look

        Tests for Extracorporeal membrane oxygenation

          Review Date: 2/2/2012

          Reviewed By: John Goldenring, MD, MPH, JD, Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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