What to expect from the Norton Children’s pediatric ECMO Program

What are the different types of ECMO?


Venoarterial (VA) ECMO (heart support) – This can assist your 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 your child’s lungs in providing oxygen to the body’s vital organs. VV ECMO only accesses the body’s venous system.

When do we use ECMO?

VA ECMO can be used in kids with weak hearts from a viral infection, kids with severe respiratory failure and kids with septic shock. Some children require ECMO briefly after open heart surgery to assist their hearts while they recover from the operation. VA ECMO can be lifesaving but also presents a risk for bleeding from anticoagulation or clotting, as well as stroke.

VV ECMO can be used in children who have very sick lungs, typically due to an infection. Using VV ECMO allows the patient’s lungs to rest so they can heal. VV ECMO also carries the risk of bleeding from anticoagulation that is necessary while on ECMO.

How ECMO works

The specially trained surgeons at Norton Children’s Heart Institute 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 oxygenated blood from the ECMO machine back to the aorta so it can go to the rest of the body.

Pain and sedation medication is delivered continuously to the patient while ECMO is performed. Your child will be sedated (asleep) while on ECMO to ensure that the ECMO connections stay in place and work properly.

You can touch and talk to your baby while he or she is on the ECMO. Patients 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 he or she is on the ECMO.

As your child recovers, the ECMO team will gradually decrease the flow to the machine so your child’s heart can take over more and more of the work. Eventually, as the heart is able to function on its own, a specialized surgeon will remove the tubes.

Continued recovery after coming off ECMO

Your child will initially breath by mechanical ventilation after your child comes off the ECMO machine. This will help to maintain appropriate oxygen and carbon dioxide levels in the blood.

The ICU team will gradually reduce your child’s reliance on the ventilator and medication. Recovery after ECMO may take weeks or months.

Why choose Norton Children’s Heart Institute

No other congenital heart surgery program in Kentucky, Ohio or Southern Indiana is ranked higher by the Society of Thoracic Surgeons than the Norton Children’s Pediatric Cardiothoracic Surgery Program.

  • Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • Our board-certified and fellowship-trained pediatric cardiovascular surgeons are leaders in the field as clinicians and researchers.
  • More than 5,000 children a year visit Norton Children’s Heart Institute, affiliated with the University of Louisville, for advanced heart care.
  • Norton Children’s Heart Institute successfully performs more than 17,500 procedures a year.
  • The Society of Thoracic Surgeons ranked Norton Children’s Heart Institute among the best in the region after studying years of our patients’ outcomes and our ability to handle a range of pediatric heart conditions, including the most severe.
  • Norton Children’s Heart Institute has satellite outpatient centers in Bowling Green, Frankfort, Owensboro and Paducah; 28 tele-echocardiography locations in Kentucky and Southern Indiana; and six fetal echocardiography locations across Kentucky.
  • The American Board of Thoracic Surgery has certified the cardiothoracic surgeons at Norton Children’s Hospital with subspecialty certification in congenital heart surgery.
  • The Jennifer Lawrence Cardiac Intensive Care Unit is under construction to give our patients the most advanced care available.
  • Our multidisciplinary approach to pediatric heart surgery brings together our specialists in cardiothoracic surgery, cardiology, anesthesiology, cardiac critical care and other areas to create a complete care plan tailored for your child.
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Norton Children’s Heart Institute

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