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