Conditions that may benefit from ECMO

If your child’s heart and lungs aren’t working, the first treatments typically include medicines and a ventilator — a machine to help your child breathe, which is connected to a breathing tube placed in your child’s windpipe. Sometimes, however, those treatments alone aren’t enough. That’s when ECMO (extracorporeal membrane oxygenation) may be considered, depending on your child’s health and needs.

ECMO has been successfully used in the following ways:

• For infants and children with severe lung conditions. Our lungs transfer oxygen from the air we breathe to the bloodstream, where it is available to all our vital organs, which are dependent on adequate amounts of oxygen to stay alive. Our lungs also remove carbon dioxide, which is toxic in high concentrations, from our blood. Sometimes, when lungs aren’t functioning because of illness or injury, the problem is so severe that it cannot be helped enough with just a ventilator (artificial breathing machine). ECMO may then be used in addition to a ventilator and medications to support lung function until the infant or child recovers or a transplant can be arranged. The most common conditions for which ECMO is used in newborns are congenital diaphragmatic hernia; meconium aspiration syndrome; severe pneumonia or infections; and pulmonary hypertension. The most common conditions for which ECMO is used in children and adolescents are severe infections (including pneumonia and bloodstream infections) and respiratory failure associated with trauma, aspiration, surgery or immune reactions.
• For infants and children who undergo cardiac surgery. Sometimes, following heart surgery, the heart doesn’t function well enough to provide sufficient blood flow and oxygen delivery to the vital organs. ECMO can be used in this circumstance to provide sufficient blood flow and oxygen to vital organs while the heart recovers. In some cases, the heart does not recover enough, and ECMO may be used as a “bridge” (temporary treatment) until heart transplantation can be arranged or an artificial ventricular assist device (mechanical blood pump) can be placed surgically.
• For infants and children who develop poor heart function due to infections or other conditions. In this case, ECMO can help do the work of the patient’s poorly functioning heart until the heart recovers, heart transplantation can be arranged or an artificial ventricular assist device (mechanical blood pump) can be placed surgically.

There are other rare conditions for which ECMO may be helpful. Pediatric specialists trained in intensive care medicine and ECMO are available 24/7 at Children’s to provide care to extremely ill newborns and children and consultation to other physicians.