ECMO for Neonates: How It Helps Babies with Critical Heart Issues

ECMO stands for Extracorporeal Membrane Oxygenation. It is a well-known method of advanced life support used for infants who are critically ill due to breathing or heart problems. The purpose of ECMO is to provide sufficient oxygen to the baby while allowing time for the heart and lungs to rest or heal. Common conditions that may require ECMO include congenital diaphragmatic hernia (CDH) and congenital heart defects. In this blog, we will explain what ECMO is, how it works, and how long a baby may need to be on ECMO.

What is ECMO?

ECMO is a type of life support system that temporarily takes over the function of the heart and lungs. It pumps the baby's blood through an artificial lung outside his body, where it gets oxygenated and then returns to the bloodstream. This treatment is usually used for newborns who suffer from serious heart or lung problems.

Neonatal conditions that can be treated with ECMO

• Congenital diaphragmatic hernia: A birth defect that affects the development of the infant's diaphragm and lungs.
• Meconium aspiration syndrome (MAS): This is a condition when the baby inhales meconium (the first stool) during delivery. This causes breathing problems.
• Persistent pulmonary hypertension (PPHN):High blood pressure in the lungs that makes it difficult for the heart to pump blood effectively.
• Severe respiratory failure: Cases where the lungs cannot take in enough oxygen.
• Congenital heart defects: Serious heart diseases that make it difficult for the heart to pump blood properly.

How is a baby placed on ECMO?

Starting ECMO involves a team of doctors and nurses working together to stabilise the baby. The ECMO pump is carefully prepared with fluids and blood before surgery. During the procedure, the doctor places catheters into large blood vessels in the baby’s neck or groin to connect the ECMO pump.

Once the ECMO system is in place, the baby is carefully monitored around the clock. The ECMO machine takes over the job of pumping and oxygenating the blood, allowing the heart and lungs to rest and heal.

How does ECMO for babies work?

ECMO works just like a heart-lung bypass machine. It's used during open-heart surgery. The machine may be used for several days or weeks. To set it up, doctors insert tubes into large blood vessels in the baby's neck, groin or chest. The location will depend on the baby's size and the type of support needed. These tubes, called cannulas, are connected to the ECMO machine. The machine moves blood from your baby (extracorporeal) to an artificial lung (membrane). The membrane lung adds oxygen and removes carbon dioxide (oxygenation). It then returns the blood back to your baby.

There are two main types of ECMO:

• Veno-arterial (VA) ECMO: This supports both the heart and the lungs.
• Veno-venous (VV) ECMO: This supports only the lungs.

How long will a new born child be on ECMO?

Depending on their condition, children typically spend one to five weeks on ECMO. We constantly monitor children's symptoms so we can take them off ECMO as soon as it is safe.

What to expect when your baby is on ECMO?

When your baby is on ECMO, the medical team will provide constant care and monitor various signs such as oxygen levels, blood pressure and heart rate. The team will work with you to explain the treatment, offer support and provide updates on your baby's progress.

It's important to know that ECMO is used when there are no other options left, as it can be risky. The baby may face complications such as bleeding, infection or blood clots. However, most babies who need ECMO are critically ill, and without it, they may not survive.

Final Word

ECMO offers a lifeline to babies with serious heart or lung conditions, providing essential support until their organs recover. Although the experience can be difficult for parents, it's important to know that the ECMO team is made up of specialists who are dedicated to caring for your baby. By temporarily taking over the functions of the heart and lungs, ECMO gives babies a chance to recover and thrive.

If your baby ever requires ECMO, remember that it’s a critical but temporary solution to give them the time they need to heal. The road to recovery might take time, but with ECMO’s support, your baby can have a brighter future.

FAQs

Is ECMO considered life support?

Yes, ECMO is a form of life support that temporarily takes over the functions of the heart and lungs.

How long can someone live on an ECMO machine?

A person can be on ECMO for a few days to a few weeks, depending on their recovery.

What is the survival rate of ECMO?

The survival rate varies, typically ranging from 40% to 70%, depending on the patient's condition.

Can a person recover from ECMO?

Yes, many people recover from ECMO, especially if the underlying cause of failure is treatable.