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New Technique - Extra Corporeal Membrane Therapy (ECMO)

By Dr. Rajneesh C Shrivastava in Cardiac Sciences

Oct 28 , 2015 | 2 min read

There was a revolution with the invention of Heart & Lung Machine. With the heart and lung machine it was possible to bypass the heart from the system and operate on it. It was a fabulous achievement. Millions of heart patients across the world could be saved by this technique. Once the baseline of cardiac patients was saved then we found another huge number of patients who need something other than the Heart and Lung Machine.

Like any other organ of our body, the Heart and Lung do get so ill that they need rest from their daily duties. But if they go on rest, the person will die. In any case they have to work. At times the condition of the patient deteriorates and eventually the death is inevitable.

Time was the major limiting factor of the Heart & Lung machine. We can support the patient on Heart & Lung machine for 6-8 hours only. There are so many conditions where there is need to bypass heart and /or lung from days to weeks. This requirement is answered by ECMO.

ECMO is a machine made up of two components, a Pump (Artificial heart) and an Oxygenator (Artificial Lung).

Pump takes 3000-5000 RPMs to pump the same amount of blood into the body as the heart does. In infections of the Heart like Myocarditis or Pulmonary Embolism the heart needs time to recover. If we keep heart on ECMO the heart is bypassed. It is in resting phase. When it recovers, it can function as if one works after adequate rest. In other conditions, where it has proved to be very successful are Cardiac Failure, Drug Overdose or Poisoning related to low BP and Cardiac Arrest less than 15 minutes. ECMO has proved its worth in patients who are waiting for Heart Transplant.
Oxygenator clears the blood of carbon dioxide and refreshes the blood with oxygen. It virtually replaces the lungs. In severe conditions like H1N1 (swine flu) where lungs give away, ECMO can take over the function of lungs and give rest to them. This gives lungs ample time to recover and start function normally. Other life threatening conditions which resolve due to ECMO are Viral and Bacterial Pneumonia, Acute Respiratory Distress Syndrome (ARDS) Pulmonary Hemorrhage, Severe Asthma, Meconium aspiration in children. It is the only answer in Rat poisoning.

All over the world it has been used on over 53,000 patients and more than 37,000 of them have been saved. This technique was long awaited. At last it is in the country. Hopefully, it will save millions of precious lives as the Heart & Lung Machine did.