ECMO: What to Expect

The ECMO machine is similar to a heart-lung machine used for open-heart surgery. The surgeon places tubes into large blood vessels, usually on the right side of the neck. If your child has had heart surgery, the tubes may be placed in the chest. From these tubes, the blood is pumped by the ECMO machine through an artificial lung which adds oxygen and takes out carbon dioxide. The blood then returns to your child. The cycle is repeated many times each minute.

ECMO temporarily provides your child with the oxygen they need and removes carbon dioxide waste product until their heart or lung problems have healed. ECMO does not cure lung or heart disease; it merely supports your child and allows time for the lungs and heart to heal. That is why we offer ECMO only to children whose lung and/or heart disease might be able to heal.

ECMO runs can range from days to weeks, and rarely months, depending on your child’s diagnosis and clinical needs.

We strongly encourage visiting. Parents and family members in good health are encouraged to visit frequently. Social workers will help you identify places to stay near the hospital if necessary.

Children on ECMO usually receive sedation and pain medicine, but often are able to mildly wake up and respond. Depending on the disease process and cannula position(s), some patients are able to wake up and rehab while others are required to move less for additional safety reasons.

There are several things you can do to help us with your child's care. These include:

• Bring special toys and comfort items
• Make sure your child hears your voice and feels your touch
• Record yourself reading stories or singing songs so they can be played when you are not here
• Have family members draw or color pictures to display at your child's bedside
• Keep a journal on your child's progress and refer to it when visiting with your child's doctors and nurses

ECMO providers – neonatologists, pediatric and cardiac intensivists, general and cardiovascular surgeons, and advanced practice providers (APPs).

The ECMO specialist has completed an intense multi-day ECMO course, in addition to ongoing training in ECMO circuit management and emergencies. The ECMO core team is an expanded clinical role supporting the hospital 24/7 to assist the bedside ECMO specialists and care team with troubleshooting and circuit procedures. There is extensive training involved in this role to ensure readiness for patient needs. 

While your child is on ECMO, you will have a critical care nurse at the bedside and an ECMO specialist in charge of the ECMO machine. Cardiac perfusionists are also involved in the care of children on ECMO, specifically those who underwent open heart surgery in the operating room.

Together, the ECMO bedside team attends multidisciplinary simulations and various training opportunities throughout the year. 

ECMO is a safe, effective therapy that provides lung and heart support for critically ill children. ECMO is only used for very sick children for whom other treatments have not helped. Like any treatment, ECMO has certain risks, including:

• Bleeding

• Blood clots

• Infection

• Seizures

• Strokes