ECMO stands for a complex therapy that involves a pump that circulates blood through an artificial lung back into the bloodstream of a very ill baby. Essentially, this system provides heart-lung bypass support outside of the baby’s body.

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 adequate oxygen to the baby while allowing time for the lungs and heart to “rest” or heal. The most common conditions that may require ECMO today are congenital diaphragmatic hernia (CDH), meconium aspiration syndrome (MAS), severe pulmonary hypertension, cardiac malformations, pneumonia, and severe air leak problems. 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 care-givers to stabilize the baby, as well as the careful setup and “priming” of the ECMO pump with fluid and blood. Surgery is performed to attach the ECMO pump to the baby via catheters that are placed into large blood vessels in the neck of the baby.

WHAT ARE THE RISKS OF ECMO?

First, because babies who are considered for ECMO are by definition very ill, they are at high risk for long-term problems, including death. In addition to the already high-risk situation, once the baby is placed on ECMO, additional risks include infection, bleeding, blood clot formation, and transfusion problems. Rarely, the pump can have mechanical problems (tube breaks, pump stops) which can adversely affect the baby.