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