INTRODUCTION TO ECMO
There are two types of ECMO: venoarterial( VA) and venovenous( VV).
VA ECMO( Femoral / Groin Cannulation)
VA ECMO allows for full heart and lung support. The goal is to allow the patient’ s heart and lungs to rest by pumping their blood to the ECMO machine through tubes, or cannulae. The ECMO machine functions as the patient’ s heart and lungs, allowing time for these organs to recover.
Blood going to ECMO n Veins( Deoxygenated) n Arteries( Oxygenated)
Blood from ECMO
A patient on VA ECMO will be cannulated in two different places. The most common cannulation sites are in the neck and groin. However, if a patient becomes unstable immediately after open heart surgery, the cannulae may be placed directly into the heart through the chest, for faster access. In such cases, the patient may come to the ICU with their chest open but with a dressing applied, to allow the heart to continue resting. Patients who are cannulated in both groins may need an additional, smaller tube called a distal perfusion catheter( DPC) to help blood circulate to the lower legs.
VV ECMO( Right Internal Jugular / Neck Cannulation)
Blood going to ECMO
n Deoxygenated n Oxygenated
Blood from ECMO
VV ECMO provides support only to the lungs. It requires the patient to have a strong and functioning heart to meet the needs of the body. VV ECMO is done by inserting a special cannula with two lumens( pathways inside the cannula) into the right vein of the neck. This allows blood to leave and return to the body through one location. In some cases, the surgeons may choose to use two cannulae, placed into veins. The ECMO system will oxygenate the blood, remove carbon dioxide, and return the blood to the right side of the heart. The patient’ s own heart pumps blood through the body, but the ECMO machine does most of the work for the lungs, giving them time to heal. Depending on their illness, patients on VV ECMO may be connected to the machine for weeks at a time. uabmedicine. org 5