Extracorporeal Membrane Oxygenation (ECMO) is a form of life support used when a patient’s heart or lungs can no longer function properly on their own. It acts as a heart-lung bypass machine, circulating blood outside the body to add oxygen and remove carbon dioxide, then returning it to the patient. ECMO takes over these functions to give the heart and lungs time to rest, heal or prepare for surgery or another type of treatment.
Understanding How ECMO Works
The ECMO machine functions as an artificial heart and lungs outside the body. It uses a combination of tubes, pumps and an oxygenator to support the patient’s circulation and breathing. The machine works by:
- Drawing blood from the body through a tube (called a cannula) placed in a large vein.
- Flowing blood into the ECMO machine, where carbon dioxide is removed and oxygen is added.
- Oxygen-rich blood is then returned to the body through another tube, either into a vein or artery.
- The system continuously monitors and adjusts blood flow, pressure and oxygen levels based on the patient’s unique needs.
This process allows the heart and lungs to rest while supplying vital oxygen to the brain and organs.
When ECMO is Used
ECMO is used in critical care situations where the heart or lungs need temporary support, such as:
- Severe heart and/or respiratory failure
- Heart attack
- Heart muscle disease (cardiomyopathy)
- Cardiogenic shock (when the heart can’t pump enough blood)
- Complications following surgery, including cardiogenic shock following surgery or post-cardiotomy syndrome
- Acute respiratory distress syndrome (ARDS)
- Pulmonary embolism (a blood clot that blocks and stops blood flow)
ECMO is a treatment used to stabilize a patient and is not intended nor able to cure a specific disease. Rather, the ECMO device provides time for additional treatment and/or for the body to heal.
What to Expect During ECMO Care
ECMO is a temporary treatment, typically lasting from a few days to a few weeks, depending on the patient’s condition. Patients on ECMO are cared for by a specialized team that includes cardiac surgeons, cardiologists, critical care nurses and perfusionists.
This care team continuously monitors vital signs, manages medications and ensures the ECMO system functions safely and effectively. Successful treatment can lead to improved survival rates and better long-term outcomes for patients.
Extracorporeal Cardiopulmonary Resuscitation (ECPR)
A newer application for ECMO is when a patient has a cardiac arrest. Extracorporeal Cardiopulmonary Resuscitation (ECPR) is the specialized use of ECMO during cardiac arrest (when the heart suddenly stops), and standard CPR is not effective.
During these emergencies:
- ECMO starts during or immediately after CPR and minimizes the risk of further injury to the organs.
- The machine takes over circulation and oxygenation functions, providing critical time for the care team to diagnose and treat the cause of the cardiac arrest.
Designated Extracorporeal Cardiopulmonary Resuscitation (ECPR) Receiving Center
The MemorialCare Heart & Vascular Institute at Long Beach Medical Center is proud to be one of only five Los Angeles County hospitals recognized as a designated ECPR Receiving Center.
ECPR has been clinically studied in Los Angeles academic hospitals since 2020. A four-year LA County Emergency Medical Services (EMS) pilot program showed that ECPR significantly improved survival in cardiac patients with a refractory ventricular fibrillation out-of-hospital cardiac arrest (OHCA).
Through this designation, Long Beach Medical Center is specially equipped and staffed with a 24/7 multidisciplinary ECPR team to provide rapid ECMO support during cardiac arrest emergencies. A highly trained team is readily available to quickly initiate ECMO to provide patients with the best chance for survival and recovery.