Extracorporeal life support (ECLS) and ECMO are advanced, life-sustaining therapies used for patients experiencing severe heart and/or lung failure.

ECMO is a type of ECLS, though the two terms are often used interchangeably.

ECLS, including ECMO, isn’t a treatment and can’t cure a patient. ECLS is a therapy that’s used to buy the body time to regain enough function of the lungs and/or heart in order to support the whole body’s proper functioning.

ECLS isn’t a guarantee that recovery will happen.

Extracorporeal membrane oxygenation (ECMO) temporarily takes over the function of the heart and lungs by pumping blood outside the body, removing carbon dioxide and adding oxygen before it’s returned to the patient. This system allows the heart and lungs to rest and heal and is often used in critical cases such as severe respiratory distress, heart failure or post-surgery recovery.

ECMO is often a life-saving intervention when conventional treatments aren’t effective.

There can be many reasons why an individual would require ECMO; your loved one’s specific reasons will be discussed in detail with the care team.

Patients need ECMO when their lungs, heart or their heart and lungs in combination are failing and they wouldn’t survive without this therapy.

There are two main types of ECMO. The type being used is dependent on whether the lungs, the heart or both the heart and lungs are failing in combination.

An ECMO circuit contains an artificial lung – or membrane – which helps do the work of the patient’s sick lungs while they’re recovering.

Yes, there are two main types of ECMO: veno-arterial and veno-venous.

• Veno-arterial (VA) ECMO is used when the heart, or heart and lungs in combination are failing. VA ECMO takes over the work of the heart and lungs completely via two separate catheters inserted into the femoral vein and femoral artery.
• Veno-venous (VV) ECMO is used when the lungs are failing and unable to provide adequate oxygen to the body. VV ECMO is usually inserted via two separate catheters in the internal jugular vein and the femoral vein, but it may also be inserted via a single catheter in the internal jugular vein.

There are many variables to consider.

When your loved one is stable, and we’ve given adequate time for their lungs and/or heart to rest, we’ll begin weaning trials.

Weaning trials involve slowly decreasing ECMO support, a process that may take several hours or days.

If vital signs and blood gases remain stable, we’ll continue weaning with the goal of being able to safely remove the catheters and ECMO support entirely.

Nursing staff may give you a password that’s used to determine if a telephone caller is allowed to access private patient information (PPI) and maintain compliance with HIPAA – a federal healthcare-related privacy law that all staff must follow.

When a patient is unable to give permission for their information to be shared over the phone, the nurse will ask the caller for the password; if the caller is unable to give the password, no patient information will be given over the phone – even if the caller says they’re a family member, loved one or close friend.

Our nurses will be very busy giving the best possible care to your loved one, so please limit the number of callers to 1-2 trusted people who can share updates with a wider group of people. While we understand the concern, and encourage you to seek community support, we want to offer your loved one our full attention.

While on ECMO, it’s possible that your loved one may have a breathing tube in place, connected to a ventilator.

For most patients, the ventilator is on the lowest possible settings to avoid ventilator-induced lung damage and promote lung healing.

Daily chest X-rays are completed to assess the lungs and ECMO catheter positions.

It is possible. It’s also important to us that we minimize any pain or discomfort that your loved one may experience, knowing that it might not be possible to eliminate all pain or sources of pain.

We can administer pain medications through a continuous IV drip, intermittent IV pushes or scheduled pills, which are crushed and administered through the feeding tube, to keep your loved one as comfortable as possible.

The ECMO nursing and care staff at Providence Portland Medical Center follow a structured daily routine that ensures expert care for all our patients. They provide regular nursing care at the bedside and manage all advanced support devices.

Our team of ECMO nurses:

• Adjust continuous medications
• Assess and adjust ECMO therapy settings
• Assist in bedside procedures
• Conduct chest X-rays
• Document vital signs every 5-15 minutes
• Measure fluid inputs and outputs at least every hour
• Perform blood tests

Your loved one’s nutrition is very important to us; however, they may not be able to eat regular food right away. Our registered dietitians (RDs) work closely with us to provide the best nutrition possible.

We prefer to feed patients through a small feeding tube inserted through their nose and into their stomach, but this isn’t always possible. Patients frequently need to have empty stomachs for various procedures or are too unstable to be fed directly.

In these cases, RDs can assist with total parenteral nutrition (TPN), which can be given to a patient through an IV. TPN is a combination of fluids, electrolytes, amino acids and fats.