KOCHI: ECMO, an abbreviation for Extra Corporeal Membrane Oxygenation, is being increasingly recognised as a treatment option in the current era. This is used as a last resort when all other treatment modalities fail to sustain the life of a patient.
ECMO can be considered as a form of cardiopulmonary bypass, a machine used in cardiac surgery. can take over the functions of the heart and lungs, thereby providing rest to these organs. Blood from the patient is circulated to this machine, oxygenated, and returned back to the patient in two ways.
In the Veno-venous method, blood from the veins is collected, oxygenated and returned back to the veins of the patient. And in the Veno-arterial method, blood from the veins is collected, oxygenated and returned to the arteries of the patient. Here, ECMO functions as an artificial heart and lungs and provides rest to both heart and lungs.
The Veno-arterial ECMO provides rest to both heart and lungs and can be used in situations like cardiac arrest, severe viral myocarditis, to tide over any residual cardiac damages after any cardiac surgery, before or after a heart transplant surgery. The Venovenous ECMO form provides rest to the lungs alone, hence is used in severe respiratory diseases like swine flu, severe injury to airways in road traffic accidents, before or after lung transplant surgery, diseases in newborn babies as diaphragmatic hernias.
This cannot be used in situations where there is irrecoverable or permanent damage to the body. Risks associated with ECMO are bleeding, infection, brain injury, damage to kidneys and thrombo-embolism.
The author is a consultant cardiac surgeon at SUT Hospital, Thiruvananthapuram.
(Views expressed by the author are his own)