Talk:Extracorporeal membrane oxygenation

Personal Anecdote

My story in regards to the E.C.M.O. machine is one of success. Our infant son, Alec, when he was born suffered from severe respiratory distress and the Doctor's did not know why. The ultrasound's performed prior to his birth did not indicate any problems, and he was 9lbs 1oz at birth. The doctor's tried conventional medicine to help his lungs heal, but to no avail. The Doctor's approached us after 4 days of the treatment, and said that Alec needs to be placed on the E.C.M.O. machine. They said that is the last resort, and if we choose not to he will not survive. We reviewed the informational booklet that explained the risks associated with the machine, and how there is a 20% chance that even with the machine he would not survive. We decided that if the Doctor's offered us this procedure, they must be confident that he could definetly benefit from it. He was on E.C.M.O. for 6 days, and let me tell you that was a rough 6 days. He retained fluid, that made him gain ~15 excess pounds. Alec looked like a "bloated bullfrog" with a huge canula tube surgically placed in the jugular vein on his right side. The machine worked, and allowed his lungs to heal on their own. We are extremely grateful and blessed with our miracle boy. There was another infant placed on the E.C.M.O. machine a day after Alec, and after about 8 days the Doctor's said that that infant would not survive. It was extremely heartbreaking to see the other family go through that, but on the other side we were relieved that our son survived. As a result of being on the E.C.M.O. machine, Alec developed "extra axial infancy fluid" in his brain that the Doctor's have said is benign, and to not worry about it. We struggle with this answer though because he goes through bouts where it seems like the pressure in his head might be hurting him because he will scream for no other apparent reason and flail about for sometimes over 1/2 hour. We have had a M.R.I. and Catscan done, and it shows the extra fluid and that the right side of his brain is not as developed as his left. We do not know if this is all related the being on the machine, or if this was just normal development. We had one Pediatrician state that this is a side affect to being on E.C.M.O. and that by 18 months it resolves itself. He is 20 months now, and it has not resolved. He also developed "toricolis" from being on E.C.M.O. because his neck had to stay in a certain position that entire time. He is developmentally behind in his gross and fine motor skills, and has low tone. He goes to physical therapy once a week, occupational therapy twice a month, music therapy once a week, and will be seeing a teacher and speech therapist soon. We would like to hear from other famillies who have had similar experiences so that we might be able to get insight from other families. We have tried to doing research on the Internet and have been unable to locate any information of substance. Please share your information with us at r_reavis@sbcglobal.net. Thank you for reading our article and we hope that it might give other families hope if they are faced with a similar situation.

--71.142.214.207 14:12, 8 February 2006 (UTC)

would the Novalung be a form of ECMO?

Hello, I recently learned of a device known as a "Novalung" that was successfully used to keep a patient alive until she could receive a heart-lung transplant. Her story is in the Feb. 15 issue of the Globe and Mail newspaper. I gather that this device has been more widely used in Europe.

1. would this device be considered a form of ECMO?

2. if so, would it be fine to mention it in the article, or failing that, to have an article of its own?

More links on the topic include:
Novalung corporate website, English version
Cardiothoracic Surgery Network 1 Sep. 2006
Medgadget Feb. 15, 2007

I don't have any commercial interest in the device, and I'm trying to figure out if there is a more "generic" term that could be used instead of the trademark "Novalung". Thanks for any input. --Kyoko 14:31, 17 February 2007 (UTC)

Actually the NovaLung is just one type of membranous oxygenating device, yes it is an ECMO devide. "ECMO" is a concept regarding the whole intensive care situation around the patient, machines, personell, medication etc. I think it's not of a great interest to mention the brand name of each detail in this complex setup while there are hundreds of pieces... /JAKE

-I would say it's not, since the E in ECMO stands for extracorporeal (meaning outside of the body). 76.15.31.146 (talk) 07:05, 27 April 2010 (UTC)

- Novalung and similar systems are ECCOR rather than ECMO, as they lack sufficient flow for oxygenation. — Preceding unsigned comment added by Bentaylor42 (talk • contribs) 14:03, 22 November 2017 (UTC)

Expanding the Article

The overall article has very little information. Someone already noted that it should be expanded, but no discussion of that has started yet. I'm sure there's more medical information that could be included in the article, but I'm especially interested in the history of the treatment/procedure.

I underwent ECMO in 1987 and I've been told it was a relatively new treatment back then, possibly even still in the experimental stages of a new treatment. What is the first known ECMO procedure (what was used, where, by whom, for what purpose) and when did it happen? How has the treatment evolved through history? There's a lot that could be said about ECMO and the current Wikipedia article only begins to address some of the material. 76.15.31.146 (talk) 07:09, 27 April 2010 (UTC)

Cost and Maintenance

Since this machine is costly to begin with and requires a lot of specialized personnel to upkeep it, it would be beneficial to know its starting point cost and maintenance cost on a monthly basis. This is important to know since the benefit of such a machine to the human population as a whole has to be balanced against high costs and individual success rate. — Preceding unsigned comment added by Eandronic (talk • contribs) 17:01, 21 December 2010 (UTC)

I think that the following could be made clearer and more informative:

Initial cannulation of a patient receiving ECMO is performed by a surgeon ->

A tube is inserted (cannulation/link) to provide oxygen to the patient's blood (sorry not able to add edit summary) ^^^^

°°°°°

Patient name in photo

There is a photograph in which the name of the patient is displayed. The naming of patients would appear unnecessary, even if consent has been given. — Preceding unsigned comment added by Xapbpoh (talk • contribs) 13:04, 7 October 2013 (UTC)

Keep mechanical ventilator on?

doi:10.1186/cc13702 review in Critical Care on ventilatory strategies while on ECMO. JFW | T@lk 10:00, 26 January 2014 (UTC)

ECMO care in transport.

Here is a article that would seem to fit here. http://www.army.mil/article/119126/BAMC_teams_with_regional_medical_centers_to_save_man_s_life/

Articseahorse (talk) 20:11, 31 January 2014 (UTC)

General review

J Hosp Med doi:10.1002/jhm.2262 JFW | T@lk 14:41, 21 October 2014 (UTC)

ECMO vs Cardiopulmonary Bypass

What is the difference between ECMO and Cardiopulmonary Bypass?

The two techniques seem similar from their descriptions, although ECMO is safe to use for longer periods. Why? The description of the two techniques doesn't seem to explain this, both seem to involve a pump and oxygenation chamber.

Wouldn't Cardiopulmonary Bypass be a form of ECMO, since the machine doing the pumping and oxygenation is outside of the body? Crazy2be (talk) 23:05, 25 April 2017 (UTC)

Bypass is similar to, but different from ECMO. If anything, VA ECMO is a simplified form of bypass. For bypass, we add in a few complexities, notably cardioplegia, aortic cross clamping and various vents, pump suckers etc. Bentaylor42 (talk) 14:06, 22 November 2017 (UTC)

Essentially, ECMO is a simplified form of cardiopulmonary bypass (CPB). A short rundown of the differences:

• ECMO has a lower flow rate then CPB because it uses smaller, cervically inserted cannulae.
• ECMO does not have a venous reservoir
• ECMO generally does not provide temperature regulation
• Depending on the type of ECMO (VV vs VA vs others), cardiac support may or may not be provided
• ECMO relies on the fact that the lungs and heart work at least to some degree; CPB completely replaces cardiac and respiratory functions 2600:1700:3B90:7330:24F5:BB31:84E2:751A (talk) 14:35, 21 March 2020 (UTC)

History section

I've added a very brief history section with a couple of sources - feel free to add to it. Absolutelypuremilk (talk) 17:53, 24 February 2019 (UTC)

Removed statement from article

There was a statement in the article that read as follows: "This intervention has mostly been used on children, but it is seeing more use in adults with cardiac and respiratory failure, especially in treatment of viral pneumonia caused by the COVID-19 Coronavirus."

This is simply not true, so I removed it. ECMO has been used across the lifespan for some time. ECMO has its uses in neonates and pediatrics, but its uses in adults are well documented and a somewhat commonplace treatment option in critical adult patients facing cardiopulmonary failure/distress. 2600:1700:3B90:7330:24F5:BB31:84E2:751A (talk) 14:19, 21 March 2020 (UTC)

Propofol should not be administered to patients under Extra Corporeal Membrane Oxygenation (ECMO)

Searching information about Extra Corporeal Membrane Oxygenation (ECMO), I found that Propofol should NOT be used in patients under ECMO, because it can produce a plasma leakage.

Watch this perfusionists training session. That part of the youtube video (/4RccN0lL7LU?t=2706) shows an ECMO machine bubbling plasma. That happens because the "membrane" is made of lots of fibbers that permeate oxygen. It is better explained in tha video.

I am not an expert, but a caution note should be included in the article, because ECMO is used along with artificial ventilation in the current COVID-19 pandemy. — Preceding unsigned comment added by 201.124.247.212 (talk) 11:52, 3 April 2020 (UTC)

References

Semi-protected edit request on 27 August 2021

Want to add the following text to the history portion of the posting.

"Extracorporeal membrane oxygenation (ECMO) was introduced into mainstream clinical practice, when Robert H. Bartlett MD utilized ECMO as a life support system in an abandoned newborn, nicknamed Esperanza in 1975. ECMO is now used in the critical care management of patients with severe respiratory and cardiac failure, septic shock, cardiopulmonary arrest, and donor organ support. Dr. Bartlett went on to found the Extracorporeal Life Support Organization (ELSO), a global consortium of health care institutions dedicated to developing and evaluating novel therapies to support failing organ systems. ELSO maintains the largest registry of active ELSO centers that use extracorporeal membrane oxygenation, including use of ECMO in the support of critical COVID-19 patients." 

REFERENCES (1) Bartlett, R. H.; Gattinoni, L. Current status of extracorporeal life support (ECMO) for cardiopulmonary failure. Minerva Anestesiol. 2010, 76 (7), 534−540.

(2) Conrad, S. A.; Rycus, P. T. Extracorporeal membrane oxygenation in critical care: past, present, and future. J. Card. Crit. Care TSS 2017, 60−64.

(3) Lorusso, R.; Alexander, P.; Rycus, P.; Barbaro, R. The Extracorporeal Life Support Organization Registry: update and perspectives. Ann. Cardiothorac Surg. 2019, 8 (1), 93−98.

(4) Barbaro, R. P.; MacLaren, G.; Boonstra, P. S.; Iwashyna, T. J.; Slutsky, A. S.; Fan, E.; Bartlett, R. H.; Tonna, J. E.; Hyslop, R.; Fanning, J. J.; et al. Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet 2020, 396 (10257), 1071−1078.

(5)  Meili Zhang, Jo P. Pauls, Nicole Bartnikowski, Andrew B. Haymet, Chris H. H. Chan, Jacky Y. Suen, Bailey Schneider, Katrina K. Ki, Andrew K. Whittaker, Matthew S. Dargusch, and John F. Fraser. Anti-Thrombogenic Surface Coatings for Extracorporeal Membrane Oxygenation: A Narrative Review. ACS Biomater. Sci. Eng.2021. Publication Date:August 26, 2021 https://doi.org/10.1021/acsbiomaterials.1c00758. © 2021 American Chemical Society

-- Write your request ABOVE this line and do not remove the tildes and curly brackets below. --> Vfap (talk) 22:01, 27 August 2021 (UTC)

 Not done for now: The tone is too promotional for me to bother fixing it. RandomCanadian (talk / contribs) 21:22, 29 August 2021 (UTC)