Health Blog

ECMO: Ultimate Treatment for heart and lungs Failur

Published on 2017-03-22 08:03:42

The whole country was stunned at the news of the ultimate lifesaving care and cardiac treatment that was administered to J.Jayalalitha who suffered severe heart attack and lungs failure. This was sudden and surprising news for all her loved ones, fans and supporters. After suffering a severe cardiac arrest, she was on assisted breathing at Apollo hospital, Chennai. A huge crowd of fans and supporters gathered at the hospital wishing her speedy recovery, but in doubt that she could have a miraculous comeback from grave danger severe this heart and lungs failure. She was on the external life support, EMCO to normalise the functioning of heart and lungs, but unfortunately she succumbed to this severe cardiac arrest and lungs failure. She was under ECMO process so that artificial oxygenated blood could supply to heart to normalise the function of lungs and heart. ECMO, the process oxygenate the cells and tissues, is a life-saving technique that follows the natural functioning of the heart and lungs, allowing an infant or adults to rest allowing the natural healing of the affected organs.

Why functioning of heart and lungs are important?

ECMO is used when the functioning and operation of heart and lungs are affected due to severe cardiac arrest or respiratory issues. This very much crucial for survival as their coordinated functioning helps oxygenated blood circulation in body. Their efforts also helps the deoxygenated blood come back to heart and exit the carbon dioxide to from body via lungs and through nose and mouth.

ECMO, Cardio vascular disease, heart, pinkmedico

As you know lungs are the pivotal organ in the body that support respiration or the breathing system. They help creating platform to convert oxygen received from the air to mingle with the bloodstream. We all know you have two lungs situated both sides of the heart, right lungs and left lung which are coordinate the for heart. You also have two: left heart consists of left atria and left ventricle, and right atria and right ventricles. The coordinated effort of lungs and heart helping the oxygen to reach and bloodstream and reach every part of the body.

When a particle of oxygen reaches lungs, it comes contact with red blood cell (RBC) which changes its colour from purple-blue to bright red. Along with other oxygen particle, the originated blood travels through the lungs and reaches heart (left atrium) through pulmonary vein. More and more blood flow make the wall of atrium expanded and when they contrasted the oxygenated blood (RBC) shoots to left ventricle through mitral valve. This is largest and strongest as it pumps out oxygenated blood to the other parts of the body through a series of vessels called arteries. Arteries strong vessels that caries purified blood to various cells and tissues in various organs of the body such as heart, lungs brain, kidney, stomach, intestine and liver. The RBC travels thought the arteries to brain where it participate in cellular respiration and other complex chemical reaction that lets the brain think and work. The RBC without the haemoglobin turns into bluish-purple and again retunes back to right chamber of the heart to pick other oxygen molecule. The cycle continues.

When you are normal health condition you inhale oxygen which enter to lungs and then enter into heart along with RBC and ultimately supplying blood to various organ of the body, coordinated effort of heart and lungs also help remove the carbon dioxide from the cells out of body. when the RBC passes an empty haemoglobin attracts the carbon dioxide particles to it. the carbon dioxide now travelling to through venous system that contains deoxygenated blood back to the right heart and then to the lungs though right atria and right ventricle and ultimately. this where the carbon dioxide gets departed from the bloodstream and exited from the body through the nose or mouth.

Functioning of heart

In normal heart functioning condition, the oxygenated blood enter into left heart (the atria) when the heart is relaxing and as more and more blood enter into the heart the wall gets expanded. Again the heart gets contracted forcing the blood to go out of atria to ventricle and then to the tissue and cells of body. The entire functioning of heart occurs automatically without the signals of brain as heart its own pacemaker upper part of the right atria that creates electrical shock that helps expansion and contraction the atria and ventricles. Usually the heart contract first the right atria and then the left atria within fraction second and then the ventricles contracted.

Absence of coordinated efforts of heart and lungs forces the use ECMO

The illness of heart and lungs can be only imagined when it requires some ultimate and critical life support and treatment to save the human life. As you know oxygen is essential for our body and the critical job of managing oxygen to reach our blood is done by the lungs. While the presence of oxygen is crucial in blood, removal of waste carbon dioxide is also essential. When lungs are extremely damaged, they do not execute their responsibilities properly which creates catastrophic concerns for the patient’s survival. similarly when the functioning of heart is not normal or due to cardiac arrest or heart it stops the expansion and contraction, doctor need artificial system that can facilitates the functioning of lungs an heart. However, thanks to the boon of medical science that come to the rescue by employing technological excellence. By administering ECMO, they make the heart and lungs function normally and patient stays alive for more days. Unfortunately, this is an artificial oxygenation process for blood, which supports to the lungs temporary.

Why is ECOMO required?

ECMO is considered ultimate life saving measures taken by the doctors to support the functioning of heart and lungs during severe heart attack or lungs failure. At some hospitals, 18 percent of newborn ECMO patients died, at others it was 50 percent. For children, death rates ranged from 25 percent to 66 percent. And for adults, they ranged from 33 percent to 92 percent. ECMO can be administered to any age group of people.

ECMO is used in infants who are sick due to breathing or heart problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal.

The most common conditions that may require ECMO are:

Congenital diaphragmatic hernia (CDH)ECMO is used in infants who are sick due to breathing or heart problems. The purpose of ECMO is to provide enough oxygen to the baby while allowing time for the lungs and heart to rest or heal.

The most common conditions that may require ECMO are:

  • Congenital diaphragmatic hernia (CDH)
  • Birth defects of the hearts
  • Meconium aspiration syndrome (MAS)
  • Severe pneumonia
  • Severe air leak problems
  • High blood pressure in the arteries of the lungs (PPHN)

It may also be used during the recovery period after heart surgery.

What is ECMO?

Extra Corporeal membrane oxygenation or abbreviated and popularly known as ECMO is life supporting technique that takes care and support the functioning of heart and/or lungs. This is called extra corporal, because the whole machine work for the patient which installed outside the body. This is an extracorporeal technique of providing both cardiac and respiratory support to persons whose heart and lungs are unable to function in natural ways. In many cases, this is considered to be the ultimate treatment option when there is no proper functioning of the internal organs like lungs or heart. Prominently, it affects the infants and elders with heart or lung disorders. In elders, this crucial step is taken typically in extreme situations after other supportive measures like survival in ventilators fail. In layman’s language, this is the process of supplying more oxygen to the blood in an artificial way. This can be compared to the functioning of the UPS or home generator in the absence the power supply.

While applying this technique doctors use a machine that pumps the patient's blood from a large vein through an artificial lung (the membrane). These machines with the artificial lungs are fixed exterior to the body or outside the body, hence, it is called extracorporeal. With the help of the artificial lung, ample oxygen can be added to the blood easily and the waste carbon dioxide can be removed. Consequently, the patient’s blood is then returned to their body into another large vein near the heart.

Types of ECMO

Out of several types of ECMO, there are two ECMO procedures most commonly used such as the veno-arterial (VA) and veno-venous (VV). In both the ECMO procedures, the oxygenation of blood happens outside the body after the blood is drained from the venous system. While in VA ECMO procedure, the blood is returned to the arterial system but blood is returned to the venous system in the VV ECMO . however, in VV ECMO cardiac support is not provided.

How Does it Work?

  1. ECMO system is created to artificially support the functioning of heart and lungs. The entire system is consists of the various component that helps blood oxygenation and pumping such as, a circuit made up of a membrane (artificial lung) a pump, a blood warmer and various monitoring components. The ECMO machine facilitates taking blood without oxygen out of the right heart and pumps it through the artificial lung i.e. the oxygenator where it comes contact with oxygen and becomes red. The oxygenated blood, is then warmed and returned to heart of the patient. this is considered the a healing process for the damage heart or lugs which allow them to take rest and heal while the ECMO works for them. The patient is continuously connected to a ventilator, that saves their lungs from collapsing the situation improves.

Throughout the ECMO procedure, doctors conduct various tests such as chest X-rays, echocardiograms and other blood tests so that the progress of the treat and improvement of the patient condition can be improved. In children arterial blood gas will be done at least twice per day to measure the amount of oxygen present in the blood. doctors administer a medicine called Heparin which avoid blood clotting in the ECMO circuit.

Survival chances

In adults the complication of the ECMO include neurological injury such as subarachnoid hemorrhage, hypoxic-ischemic encephalopathy, ischemic infarctions in brain, unexplained coma, and brain death. The major challenge of ECMO is bleeding in 40 to 40 percent people which can be proved life-threatening.

Since the implementation of this technique is an ultimate option to the patients with damaged lungs or heart, changes of the survival are very less. While risks of the bleeding, infection, and malfunction of the machine can create potential complexities, the doctors say the age of the patients and severity of the condition also matters. The very use of this medical technique indicates the severity or criticality of the lungs’ illness. This kind of illness, hence, can be classified as advanced cardiac life support.

Heart, cardio vascular disease

ECMO has been facilitating the operational functioning of heart and lung in case of severe respiratory complexities and cardiac failure as a temporary artificial support system. As an cardiopulmonary bypass offshoot membrane oxygenator ECMO can be can be used in all ages groups. Though this is creating catastrophic concerns in new born babies and older children in case of respiratory failure or cardiac failure, it also creating alarming concerns in the adults with respiratory and lungs failure. This is not a treatment, rather a life support. ECMO process buys life for the patients. Hence, ensuring the proper functioning of heart and lungs can avoid the using the extracorporeal life support for oxygenation. .