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The ECMO or extracorporeal membrane oxygenation therapy is mostly known for its artificial blood oxygenation quality. It is just like an ordinary heart and lung bypass machine, used in major cardiac surgery. But, nowadays ECMO is considered a blessing for those who are knocking on the door of death, because of covid-19.
According to Dr.Matthew Paden (former president of ELSO) says,” ECMO is a critical therapy and it doesn’t sound wonderful for some of you. , But all you have to remember that all the critically ill covid-19 patients would have died if they have not had this therapy.”
What is ECMO therapy?
For the people whose hearts and lungs don’t work properly due to covid-19 or others causes, ECMO is worked like a miracle. This functions as an artificial heart and lung machine. And do the blood pumping and oxygenation outside the human body.
Moreover, ECMO can maintain the normal heart rate and respiration despite the devastating lungs and heart condition. Also, the outcomes of this therapy are really amazing. And ECMO makes a remarkable increase in the survival rate in covid-19 patients as compared to other modes of treatment.
Who are the beneficiaries?
ECMO is an anciently used therapy. In the early days, it is used for newborns and infants having respiratory distress and other cardiac abnormalities. But, recently ECMO is used to treat critically ill patients. They are like covid -19 patients who are on ventilators.
Also, the patients whose oxygen level is not maintained by the mechanical airways. And for the people undergoing organ transplants. They all get the benefits from this ECMO therapy.
Sometimes, this therapy doesn’t work for some particular patients. The aged people having chronic diseases like diabetes and high blood pressure along with covid-19 have the least chance to get the ECMO benefits.
How does ECMO therapy work?
The ECMO therapy conducts through an ECMO machine. In this, the machine has connected the large vein, arteries of the chest, neck, or leg of the person by a long plastic tube. This process is called cannulation.
After cannulation, the deoxygenated blood (co2 riched) flows out from the heart by that tube and enters into the ECMO machine. There is the oxygenation process takes place like the human’s lungs. It converts the deoxygenated blood into oxygenated.
After completing the oxygenation, the ECMO machine sends the oxygen riched blood via a long tube. Here the oxygenator pumps the blood in the same force as the heart. So, it replaces the function of the human heart.
How does ECMO work for covid-19 patients?
Some respiratory and cardiovascular diseases like pneumonia, influenza A and B, and covid-19 affects the pumping and oxygenation. As a result of which, the c02 level is increasing in the body. It causes acidosis and other morbid conditions.
So, when the patient undergoes this therapy. The blood oxygenation and pumping action have done by the ECMO machine itself. There is also a device, RVSD ( right ventricular support device) that has been placed inside the body through a tube.
The tube goes down through the neck vein then goes to the right atrium, right ventricle to the pulmonary artery. It carries the deoxygenated blood from the pulmonary artery through the tube. Then the deoxygenated blood goes to the ECMO machine. The oxygenation process takes place there.
What happened then?
Another tube is connected from the machine to the pulmonary artery. It sends the oxygenated blood inside the heart. As the blood goes to the pulmonary artery has an increased level of oxygen so, the pulmonary vascular resistance becomes decreases. Lastly, the chance of ischemia is minimized.
The ECMO therapy reduces the chance of cytokine storm. And indirectly increases immunity. It is a life-saving therapy for critically -ill covid patients. To get more information, there is a guideline given by the American thoracic society on ECMO.
How does it feel to be on ECMO?
Before the procedure, the patient is on sedation. He or she doesn’t feel the tube that has inserted into the pulmonary artery through the vein or the arteries. Then the blood goes to the oxygenator and becomes oxygenated.
When the therapy is going on, a breathing machine connects to the mouth of the patient. It is for proper ventilation. Some medicines also administer which are act like sedatives.
How long ECMO therapy is used?
It is a life-saving therapy with life-supporting benefits. It doesn’t resolve the problem related to the injury that led to heart failure. But, the longer use of ECMO helps you to overcome those problems.
Its uses for some patient who is undergoing organ transplant as well as for the treatment of cardio and respiratory problems. They need this therapy for a limited period whereas some need longer to get recover.
To initiate the whole process, a surgeon has to insert the device. A trained medical personal is to run the ECMO machine. Also, another staff has to monitor the machine as well as do the blood gas analysis.
What are the risks of this ECMO therapy?
The chances of bleeding from the different parts of the body are increasing. The use of blood-thinning medication to prevent clots makes this kind of complication. But, the proper observations of the health care team keep you out of this problem.
Failure in kidney
In ECMO therapy, blood doesn’t reach the kidney sufficiently. It makes the kidney prone to acute renal failure. In such cases, a patient needs dialysis also.
As the blood goes outside the body, it increases the chance of bacterial growth. And led to infections mostly in the lungs.
Damage in the legs
In some cases, the cannula connects to the vein in the groin. So, it impairs blood flow in the legs. And at last, the leg becomes amputated.
It occurs due to this therapy. Blood can’t reach vital organs like the brain. The small clots are from there. and cause stroke in the patient.