What To Expect If Your Child Needs ECMO

Extracorporeal membrane oxygenation (ECMO), a cardiac and respiratory support system, circulates blood outside a child's body so that the heart and lungs have a chance to heal.

Here's what you need to know about the process if your physician tells you your child needs ECMO.

Information and Consent

A care team member will review the risks and benefits of starting ECMO with you, and answer any questions you have before the process is started. With your consent, a surgeon will proceed with the ECMO setup.

Members of the ECMO team will visit you in your child’s room each morning to discuss a plan of care for the day.

The ECMO Machine Oxygenates the Blood

To provide a direct line to your child’s heart, one or more plastic tubes called cannulas are surgically placed into large blood vessels of your child’s body, most often in the neck, leg or chest. The tubes drain blood from the heart into the ECMO circuit.

As the blood is pumped through the circuit, oxygen is added, and then the blood flows back into your child’s body.

With the machine helping, the lungs and/or heart have a chance to recover.

A Ventilator Keeps Air Flowing Through the Lungs

Even though the ECMO machine is doing most of the work for the lungs, your child will also use a breathing machine called a ventilator.

The ventilator works through a tube in the nose or mouth that sends just the right amount of air pressure in and out of the lungs. The moving air helps your child’s lungs stay slightly expanded.

Swelling Is Expected

Many children become very swollen during their first few days on ECMO. The swelling, known as edema, may be unsettling to see, but the care team is familiar with this side effect and will make sure the ECMO machine is working properly. Usually, much of the edema disappears by the end of ECMO treatment.

In most cases, children are sedated (asleep) while on ECMO. Those who are awake are protected from pain or discomfort with pain medication given through an IV (a small tube inserted in a vein) or directly through the ECMO machine.

We can give extra doses of pain medication if your child seems uncomfortable.

When the Treatment Is Over

When the treatment is finished, a surgeon will remove the tubes.

Learn more about ECMO at The Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital.