ECMO (Extra-Corporeal Membrane Oxygenation)

ECMO provides life-saving support for patients with critical illnesses.

ECMO (Extra-Corporeal Membrane Oxygenation) is a life-support machine used in patients with life-threatening heart and/or breathing problems. When the heart does not pump enough blood or the lungs do not provide enough oxygen, ECMO can be used to assist the heart and/or lungs while giving the body a chance to rest.

What does ECMO do?

•  Helps the lungs get oxygen into the blood and removes carbon dioxide
•  Helps the heart by pumping the blood to the organs and body

Types of ECMO

VA (Veno-Arterial) ECMO, which gives full cardiac and respiratory support. The ECMO functions as the person’s heart and lungs and allows the organs to recover. VA ECMO is used for:

• Cardiogenic shock
• Post cardiotomy support
• Myocarditis
• Cardiac arrest
• Pulmonary embolism
• Pulmonary hypertension and right heart failure
• Medication overdose
• Bridge to transplant
• Non-ischemic cardiomyopathy

VV (Veno-Venous) ECMO, which only supports the lungs, requiring the heart to be fully functional. The ECMO acts as the patient’s lungs and oxygenates the blood while the lungs are recovering. VV ECMO is used for:

• Acute respiratory distress syndrome
• Acute respiratory failure
• Pre-lung transplant trauma

How long can ECMO be used?

An ECMO machine can help save a life, but it is not a cure for any disease or injury. Typically, patients are on VV ECMO much longer than VA ECMO since it takes the lungs longer to recover. Patients awaiting transplant may also be on ECMO until organs become available. Many physicians try to get patients off ECMO as quickly as possible since ECMO does not come without risks. Some common risks from ECMO include:

• Bleeding due to prolonged anticoagulation
• Stroke or seizures
• Blood clots
• Swelling/edema
• Kidney failure requiring dialysis
• Limb ischemia

About the WVU Medicine Adult ECMO Program and Care Team

The Adult ECMO program at WVU Medicine – the only one of its kind in the state – is a nationally recognized Center of Excellence, providing the highest level of care and outcomes.

The WVU Heart and Vascular Institute was recognized with the ELSO Center of Excellence Silver Life Support Award from the Extracorporeal Life Support Organization (ELSO) which recognizes those centers that demonstrate an exceptional commitment to evidence-based processes and quality measures, staff training and continuing education, patient satisfaction, and ongoing clinical care.

A designated Center of Excellence has demonstrated extraordinary achievement in the following three categories:

• Excellence in promoting the mission, activities, and vision of ELSO;
• Excellence in patient care by using the highest quality measures, processes, and structures based upon evidence; and
• Excellence in training, education, collaboration, and communication supporting ELSO guidelines that contribute to a healing environment for families, patients, and staff.

The ECMO Air Response Transport Team is a group of specially trained surgeons, perfusionists, nurses, and specialists, who are able to transport critically ill patients. The team’s specially equipped aircraft includes a portable ECMO machine and other advanced equipment. The team can mobilize within two hours of transfer request and is on call 24 hours a day, seven days a week. It has an accessible range of 119 nautical miles.

The WVU Medicine ECMO Ground Team remains available throughout the transfer process, helping manage real-time information while the ECMO Air Response Transport Team is in route.

Adult ECMO Referral Process

Timing is critical, and it is important to know when ECMO is the right option for your patient. Any patient with severe hypoxia despite 100% oxygen is a candidate.

To arrange for patient transfer to our ECMO Program, call the Medical Access Referral System at 800-WVA-MARS (800-982-6277).

Specialized cardiothoracic surgeons trained in advanced respiratory failure and ECMO will quickly obtain a thorough history and offer management guidance in consultation with your team. The ECMO team rapidly evaluates the case to determine candidacy for ECMO or potential transfer without ECMO, when appropriate. If accepted, our access transfer team will send you a checklist to help prepare the patient for transfer while our mobile ECMO transport team is deployed to your hospital.