Extracorporeal membrane oxygenation: Approach to Care
Extracorporeal membrane oxygenation, or ECMO, is an innovative technology that assists patients whose lungs (or heart) need assistance while they are recovering from an acute illness, accident or waiting for a transplant.
ECMO acts as an artificial lung (or heart), pumping blood from the patient’s body into the device. The device then removes carbon dioxide from the blood, oxygenates it, and pumps the oxygenated blood back into the patient’s body.
UF Health offers an innovative ECMO device called the Cardiohelp System — the world’s smallest ECMO device, about the size of a shoebox. The smaller size and flexible cannulas (thin, flexible tubes) allow patients to get up and move around, helping to ensure that their bodies stay strong and conditioned during their path to recovery or transplant.
ECMO Center of Excellence
At UF Health, our staff is constantly exploring new ideas and innovations that will help our patients. Technologies such as ECMO allow our lung transplant team to help more lung transplant patients and save more lives. As of July 2018, our team has implanted ECMO technology into 70 patients — 40 adults and 30 children. Due to our experience and expertise, The Extracorporeal Life Support Organization has given UF Health its Gold Level ELSO Award for Excellence in Life Support for our exceptional care in both our pediatric and adult programs.
Our ECMO Team
Every patient who needs ECMO receives care from multiple health professionals, including:
- Thoracic surgeons —Dr. Mauricio Pipkin and Dr. Tiago Machuca
- Critical care physicians — Dr. Hassan Alnuaimat and Dr. Andres Pelaez, who provide medical care for the patient’s comprehensive health needs
- ECMO specialists — specially trained respiratory therapists or nurses who are at the patient’s bedside 24/7 to care for the ECMO device and troubleshoot any problems
- ICU nurse — cares for the patient’s urgent healthcare needs
- Physical and occupational therapists — keeps the patient active and protects his or her muscles from atrophy (gradual decline in effectiveness)
Candidates for ECMO
Our ECMO team uses the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score to help decide which patients are good candidates for ECMO. The RESP score helps predict the survival rate for adult patients who may be undergoing ECMO, which helps avoid futile (ineffective) treatment.
Benefits of ECMO
The portable Cardiohelp System helps patients who need a lung transplant to maintain life and stay active until a lung is available. This artificial lung technology also allows injured and damaged lungs to rest. For patients with acute (sudden) injuries, the rest time gives their lungs an opportunity to recover. For lung transplant patients, ECMO helps them breathe and stabilize or improve their health until it’s time for their transplant.
When patients are undergoing ECMO, family support is critical:
- Family and support people help patients stay motivated and get up and moving.
- When patients have been in an induced coma and suddenly awaken, they may feel vulnerable and anxious. Having family around helps patients understand what is happening and provides much-needed psychological support.
- Family is also important when it comes to making care decisions. If a patient isn’t recovering or becomes futile (unable to recover), family helps make end-of-life decisions by discussing the patient’s wishes and quality of life.
ECMO treatment has evolved thanks to technological and care innovations. Our UF Health transplant team is pleased to offer patients better treatment options and outcomes.