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    Understanding ECMO: Life-Saving Cardiac and Respiratory Support at Apollo Hospitals Karnataka

    Understanding ECMO: Life-Saving Cardiac and Respiratory Support at Apollo Hospitals Karnataka

    May 24, 2024

    ECMO

    New discoveries in the medical field of critical care medicine constantly stretch the bounds of what can be done to save lives. Extracorporeal Membrane Oxygenation (ECMO) is a significant and innovative advancement in life support techniques that assist patients suffering from severe lung or heart failure by providing both cardiac and respiratory support. From its inception in the 1970s, ECMO has been elevated to a high degree of technological intervention that provides patients with a lifeline in times of critical illness. Let’s get into the details.

    What is ECMO?

    Extracorporeal Membrane Oxygenation, or ECMO, is a type of life support for patients who have a life-threatening disease or incidents that impair the function of their heart or lungs. In contrast to conventional life support techniques, ECMO entails the temporary bypassing of the heart and lungs. ECMO maintains blood circulating through the body while also maintaining blood gas balance (oxygen and carbon dioxide). ECMO does not treat lung or heart problems but temporarily relieves their functions, enabling them to “rest.” It makes use of an external machine (extracorporeal), and this machine circulates blood, supplies oxygen, and helps with the body’s elimination of carbon dioxide. For the purpose of allowing your heart and lungs to recuperate after a respiratory illness, heart attack, or trauma, ECMO therapy can be quite helpful.

    Why is it done?

    The main purpose of ECMO is to sustain patients who are not responding to traditional treatments and have severe cardiac or respiratory failure. Acute Respiratory Distress Syndrome (ARDS), cardiogenic shock, postcardiotomy syndrome, and severe pneumonia are a few examples of these ailments. When this happens, ECMO acts as a temporary solution to help the patient heal until the underlying medical condition goes away or they are able to receive more permanent treatments like lung or heart transplants.

    Many different serious medical conditions affecting the heart and lungs can be treated using ECMO. Common indications of ECMO for adults include:

    Acute Respiratory Distress Syndrome (ARDS)

    Acute Respiratory Distress Syndrome might result from lung damage that impairs the ability of the lungs to absorb oxygen from the blood and expel carbon dioxide. This can occur with:

    • Respiratory illnesses such as pneumonia, flu, and the new coronavirus that cause COVID-19, among others
    • Burns and damage from inhaling. Your lungs may be harmed by breathing in hot air from smoke, fire, or hazardous chemicals and fumes.
    • Ingesting something through your mouth, such as food, drink, vomit, or water.
    • Sepsis, which causes lung damage.

    Pulmonary Embolism

    The condition of pulmonary embolism develops when a blood clot originating in your body—usually from your legs—moves towards and becomes lodged in your lungs. This might prevent blood from entering the lungs, which might result in fatal heart/lung failure.

    Surgery & Transplants

    ECMO can act as a “bridge” till a patient is able to get the necessary treatment. When a patient is awaiting a heart/lung transplant or during some other periods, medical professionals employ ECMO.

    Cardiogenic Shock

    A medical condition that occurs when the heart can’t pump blood fast enough to fulfil the body’s needs frequently develops following a heart attack or severe heart failure.

    These are just a few instances; ECMO may be modified to assist patients with a wide range of other serious medical conditions, offering critical care doctors a flexible tool for their toolkit.

    How does ECMO operate?

    In order to provide critically sick patients with both cardiac and respiratory support, ECMO, or extracorporeal membrane oxygenation, temporarily replaces the function of the heart and lungs. A perfusionist, a specialist in using the ECMO equipment in the critical or Intensive Care Unit (ICU), administers ECMO treatment. The ECMO machine’s parameters are adjusted by the perfusionist, who also keeps a close eye on the patient. Cannulas, which are plastic tubes, are inserted into the patient’s neck, chest, and leg’s big veins and arteries once they are sedated and comfortable. These cannulas will be attached to the ECMO machine. Subsequently, the blood is circulated via an external circuit consisting of a pump and an artificial lung (oxygenator). To simulate how the lungs exchange gases, carbon dioxide is taken out of the blood and oxygen is supplied in an oxygenator. After that, the pump bypasses the heart and lungs and returns the oxygenated blood to the patient’s body.

    ECMO treatment is often given in the critical care unit. Throughout the procedure, a team of specialist healthcare experts monitors ECMO to maintain its optimal functioning and adjusts settings as needed.

    When is it OK not to use an ECMO machine?

    Older adults are less likely to benefit from ECMO. You can get advice about the advantages and hazards of ageing from your doctor. There are several situations or scenarios in which ECMO is not a viable solution. These consist of:

    • When the patient has irreversible circulation, lung, or cardiac issues that cannot be resolved by transplantation.
    • Injuries that resulted in uncontrollable bleeding or uncontrollable internal bleeding, particularly in the head
    • Those who have injuries to their brain or liver, among other vital organs.
    • Cancer that has proliferated since its origin

    What benefits come with using an ECMO machine?

    Because of its many benefits, the ECMO procedure is a useful treatment alternative in critical care environments. The following outcomes are possible with this treatment:

    • Even in the most severe situations of heart or lung failure, ECMO ensures crucial oxygenation and circulation by providing quick and efficient assistance for both cardiac and respiratory functions.
    • Maintains a patient’s life during surgery or other medical operations.
    • By lowering ventilator settings, ECMO minimises lung damage caused by the machine and gives the lungs a chance to recover.
    • Benefits newborns who have underdeveloped lungs or cardiac problems at birth.
    • ECMO can act as a lifesaver, giving patients the essential assistance they need while they wait for an organ transplant or recover from illnesses that can be reversed.
    • ECMO gives hope to patients suffering from life-threatening conditions because it is linked to better survival rates in some patient populations.

    Risks or Problems Arising from Using an ECMO Machine

    Even though an ECMO machine is a very useful medical device, there are some serious risks associated with it.

    • The likelihood of blood clots developing requires blood thinners for everyone on ECMO. Additionally, blood flow might be disrupted by clots that become lodged in the ECMO circuit.
    • The need for tubes to enter large veins and arteries might make you more vulnerable to bleeding.
    • An infection might enter your bloodstream through any skin cut, and the tubes of an ECMO circuit could also be a source of infection. An infection might spread throughout your body more easily as a result of this.
    • Strokes can happen from clots in the circuit that end up migrating to the brain, or they can happen as a result of spontaneous bleeding in the brain during ECMO support.
    • The ECMO circuit as a whole might shut down due to mechanical breakdown in any one component.

    Apollo Hospitals, Karnataka – The Premier Choice for ECMO Care

    The Apollo Hospital in Karnataka is a national leader in critical care, especially when it comes to ECMO treatment in Bangalore. With a staff of highly qualified doctors and modern infrastructure, Apollo Hospital provides unmatched experience in ECMO treatment. When looking for the best ECMO centre in Bangalore, Apollo Hospitals is the first pick because of its state-of-the-art equipment and caring medical staff. The hospital offers cutting-edge equipment and some of the most prominent professionals to guarantee that patients receive the best care possible. At Apollo, the success rates for ECMO procedures are astounding, with minimal risk.

    For any further information or medical assistance, contact Apollo Hospitals, Karnataka.

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