Updated June 24, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: What is ECMO in the NICU?

My baby is very sick, and his doctor wants to place him on ECMO. What does this mean?

Answer:

What is ECMO?

ECMO is an abbreviation that stands for extracorporeal membrane oxygenation. An ECMO machine is a machine that takes blood from the body, oxygenates it using an artificial lung, and pumps it back into the body using an artificial heart. ECMO is similar to a heart/lung bypass machine used in open heart surgery, but can be used for a longer time.

Who Needs ECMO?

ECMO is a complicated treatment, so it is used only for babies who are very sick and would probably die without it. ECMO may be considered for babies with:

• Meconium aspiration syndrome
• Persistent pulmonary hypertension of the newborn (PPHN)
• Severe respiratory distress syndrome
• Life-threatening infection or pneumonia

ECMO may also be used for any serious condition that causes a baby's heart or lungs to stop working well. Because ECMO can only be used for up to a few weeks, it is only used for patients who are expected to recover after treatment or surgery.

How Does ECMO Work?

To start ECMO, doctors will place long tubes called catheters into a baby's blood vessels. The catheters may go in through a small incision in the baby's neck or groin, and will travel to the large vessels near the baby's heart.

Once the catheters are in place, doctors will hook them up to the ECMO machine tubing, which will already be filled with donor blood. When the ECMO machine is turned on, it will drain blood from the baby, pump it through a membrane that adds oxygen and removes carbon dioxide, and return the oxygenated blood to the baby.

What Are the Risks From ECMO?

Because there are a number of risks associated with EMCO, it is only used in babies who are so sick that they may die without treatment. Risks include:

• Bleeding: Heparin, a blood thinner, is used to prevent blood clots during ECMO treatment. Heparin may cause bleeding from where the tubes are inserted or in other parts of the body.
• Infection: Any time a foreign object, such as an ECMO catheter, is put into the body, it can cause infection.
• Intraventricular hemorrhage (IVH): Bleeding into the brain is a serious complication of ECMO treatment.
• Blood clots: Small blood clots may form in the ECMO tubing. These clots may travel through the blood stream and cause injury or even death.
• Blood transfusions: Frequent blood transfusions may be needed when a baby is on ECMO. Although the blood supply is very safe, there is always a risk of disease from donor blood.

<sub>Sources:

Cincinnati Children's. "Surgical Options: Extracorporeal Membrane Oxygenation (ECMO). Accessed March 26, 2011 from http://www.cincinnatichildrens.org/health/heart-encyclopedia/treat/surg/ecmo.htm

Stanford School of Medicine Lane Medical Library. "Introduction to ECMO for Parents" Accessed March 26, 2011 from http://lane.stanford.edu/portals/cvicu/HCP_CV_Tab_1/ecmo_for_parents.pdf</sub>