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Venoarterial (VA) ECMO (heart support) – This can assist the child’s heart and lungs in providing blood flow and oxygen to the body’s vital organs. Tubes are inserted into the arterial and venous systems of the body.
Venovenous (VV) ECMO (lung support) – This can assist the child’s lungs in providing oxygen to the body’s vital organs. VV ECMO only accesses the body’s venous system.
VA ECMO can be used in children with weak hearts from a viral infection, with severe respiratory failure and those with severe infection. Some children require ECMO briefly after open heart surgery to assist their hearts while they recover from the operation.
VV ECMO can be used in children who have very sick lungs, typically due to an infection. Using VV ECMO allows the child’s lungs to rest so they can heal.
The specially trained surgeons at Norton Children’s Hospital will insert two plastic tubes called cannulas into the large blood vessels. Typically, these tubes are inserted through the neck and provide the ECMO machine direct access to blood near the heart.
One tube removes deoxygenated blood out of the body and into the ECMO machine. Fresh oxygen is added to the blood and carbon dioxide is removed as the blood flows through the ECMO machine.
The second tube carries the blood with oxygen from the ECMO machine back to the aorta so it can go to the rest of the body.
The child will be given pain medicine while on ECMO to ensure the child is comfortable and that the ECMO connections stay in place and work properly.
You can touch and talk to the child while they are on ECMO. Children can hear and recognize the sound of their parents’ voices even while they are sedated. One of our ECMO specialists will help you understand when it is safe to interact with your child while on the ECMO.
As the child recovers, the ECMO team will gradually decrease the flow to the machine so the heart can take over more and more of the work. Eventually, as the heart or lungs are able to function on their own, a surgeon will remove the tubes.
The child will initially breathe by mechanical ventilation after coming off the ECMO machine. This will help to maintain appropriate oxygen and carbon dioxide levels in the blood.
The ICU team will gradually reduce the child’s reliance on the ventilator and medication. Recovery after ECMO may take weeks or months.