WHAT TO EXPECT WHILE ON ECMO THERAPY
Another common therapy you may see used with ECMO patients is continuous renal replacement therapy ( CRRT ), pictured to the right . CRRT replaces the normal bloodfiltering function of the kidneys when the kidneys are not working well or no longer making urine . The patient ’ s kidney function may return over time , without requiring long-term dialysis .
When patients start on ECMO therapy , usually they are on several medications . They will have pain medication and / or sedation to make sure they are comfortable . They likely will be on antibiotics to treat or prevent infection . Some patients may be on a drug called heparin , to help prevent clots from forming in the blood or ECMO system . Other patients may have heparin discontinued after a time or never require the use of heparin . Patients may have multiple other medications running through IVs or central lines to help their kidneys , heart , and lungs or to treat other issues related to their medical problems . As they get healthier , patients may not need some of these medications any longer .
For patients on ECMO therapy for an extended time , their nutritional needs may be met through a tube placed directly in their stomach , until they show signs of recovery . If they are on a ventilator for an extended time , the endotracheal tube may be exchanged for a tracheostomy ( a shorter tube surgically placed in the neck and connected to the ventilator ).
The healing process for the heart and / or lungs may take days or weeks . To assess the patient ’ s progress while on ECMO , the care team will review lab results to check organ function , infection status , and recovery . Chest X-rays will be used to monitor the progress of the lungs and the placement of the cannula . Other tests may include CT , ECHO , and bronchoscopy . A computed tomography ( CT ) scan , usually of the brain , allows the care team to look for bleeding or other problems . An ECHO ( echocardiogram ) is an ultrasound that allows the care team to see the function of the heart . A bronchoscopy is a procedure usually done at the bedside , to look inside the lungs with a camera .
While on ECMO , your loved one will be in bed . The longer they are confined to bed , the longer it will take them to get back to normal once they are off ECMO , because muscles that are not used get smaller . To minimize muscle loss , physical therapists and / or occupational therapists will do exercises with your loved one . They may start with small movements in bed and progress to sitting or standing up . Over time , some patients may be able to walk a few steps or short distances with the assistance of the care team .
8 Family Guide for Patients Who Need ECMO