What happens while on ECMO?
Monitoring patients during extracorporeal membrane oxygenation (ECMO)
Your family member will continue to be watched very closely. Our team monitors your loved one using X-rays and photos to make sure tubes are in the right place and to see if the lungs are looking better. We also take blood samples to test for improvements.
Treating pain during ECMO
We typically give ECMO patients medicine to make them sleepy and to decrease pain. We watch your family member closely for signs of pain.
Allowing movement during ECMO
If safety allows, we treat patients with less sleep medicine so there can be more awake and move their arms and legs a little. Some of our patients have been able to walk while on ECMO.
Preventing blood clots and bleeding during ECMO
We typically provide a medicine called heparin to help thin the blood. Heparin keeps the blood from clotting in the ECMO machine. Because Heparin makes it easier to bleed, our team watches for signs of bleeding. We take blood samples to see that there’s a healthy balance between bleeding and clotting.
Bleeding from the cannulae can happen. We will monitor for it and take the necessary action should it arise.
Blood transfusions while on ECMO
ECMO patients may need a blood transfusion while on ECMO. Blood comes from our blood bank where they do many tests to make sure the blood products we give your family member are safe.
Patients on ECMO are usually helped with their breathing by having a tube called an endotracheal tube (ET tube) placed in their mouth. The tube will be attached to a ventilating machine to help support the patient with breathing, and in some cases will actually breathe for them.
Preventing lung infections during ECMO
Sometimes a patient has an infection in the lungs and the medical team can use the ET Tube to suck mucous out of the lungs. This helps keep the lungs free of mucous and infection.
If the medical team feels the breathing tube cannot come out, they may speak with you about changing to a tracheostomy tube (trach tube). A trach tube is placed into the wind pipe (trachea).
Sometimes patients (usually adults) can have the ET tube removed while on ECMO.
Healing the lungs while on ECMO
Sometimes we will move an ECMO patient on to their stomach to help their lungs get better. This process is called “proning,” because the patient is in a prone position.
The doctor may want to look inside the patient’s lungs to see if the lungs are healing. The procedure to do so is called a bronchoscopy or “bronch.” A bronchoscope is a special microscope that looks like a long tube. The doctor will insert the scope into the wind pipe either through the breathing tube or the tracheostomy tube. Mucous and infection can be removed through the scope and sent to the lab for testing.
Nutrition during ECMO
Your loved one’s nutrition may come from different sources including medications called central venous nutrition (CVN) and lipids, given through a vein. Some patients may have a tube placed in their nose and are given liquid nutrition directly into their stomach. CVN provides essential vitamins and electrolytes and lipids provide fat. The body needs fat to maintain calories. A patient can receive food by mouth if they no longer have an ET tube and the medical team feels it is safe.