What is an ECMO (ECMO) machine?
ECMO (ECMO) is the full name. Extracorporeal Membrane Oxygenation is a device used to increase oxygen levels and reduce carbon dioxide levels in the bloodstream from outside the body. For patients whose lungs and heart cannot adequately exchange gases under normal conditions In Thailand, ECMO machines are used in medical schools and major hospitals across the country. Chulalongkorn Hospital, the Thai Red Cross Society, began using the ECMO machine for the first time in the intensive care unit following cardiothoracic surgery (CVT ICU) since 2011. It was introduced in 2003 and was first used in the pediatric intensive care unit (PICU) in 2011. According to the report, the neonatal pulmonary and cardiac support survival rate was 70. The survival rate in children and adults is similar, 40-50%, but when compared to patients without resuscitation by ECMO, the mortality rate is as high as 90%. quite
What kind of patients need ECMO (ECMO)?
The characteristics of patients who need ECMO (ECMO) are critically ill patients with severe heart failure and patients with severe respiratory failure. Or in some cases, both symptoms may be combined. There are three operating systems of ECMO:
1. Veno-Arterial (VA) for severe heart failure or both pulmonary and heart failure.
The device draws blood from large veins, such as from the neck in young children. or legs in older children and adults And through an artificial lung machine to increase oxygen and help exchange carbon dioxide back into the upper or lower aorta
2. Veno-venous (VV) for severe respiratory failure
The machine will suck blood from the large veins through an artificial lung. and into the major veins once more
3. Arterial-venous For moderately severe cases of respiratory failure
This will apply pressure from the arterial side without the use of an artificial pulmonary traction machine.
However, the use of ECMO (ECMO) has limitations for some groups of patients with certain concomitant factors, such as patients with terminal cancer, patients who have been using mechanical ventilation for a long time. or patients with aortic rupture, etc.
It was also found that the use of ECMO (ECMO) also caused some side effects to patients, such as cerebral hemorrhage, leg ischemia. (in patients using the Veno-Arterial ECMO system), hemolysis, sepsis, thrombocytopenia, etc., which doctors and nurses Patients must be closely monitored and supervised 24 hours a day.
Therefore, the use of ECMO to save the lives of critically ill patients It requires a joint decision between the doctor and the patient’s relatives. by assessing the severity of the disease indications and risk factors. ECMO is an advanced medical technology. have a high cost And it must be a multi-disciplinary collaboration that requires specialized personnel.
References: Chulalongkorn Hospital, Thai Red Cross Society
