It is an extracorporeal perfusion technique that provides oxygenated blood to the patient. Can be a short or long term solution. The ECMO circuit is composed by: a centrifugal pump, an oxygenator, cannulas and a heater cooler.
Prior on initiating the ECMO, cannulas are placed in the patient vein or arteries and are connected to the circuit. Once the medical team are ready, the perfusionist activates the ECMO machine. The patient’s blood is drained from the venous circulation. The blood reaches the centrifugal pump and it is pushed into the oxygenator. Here the blood gets oxygenated, warmed up and retuned back into the patient blood circulation.
The perfusion manages the amount of oxygen and air flow delivered to the oxygenator to reach an appropriate exchange of O2 and CO2.
the VA ECMO drains venous blood, oxygenates the blood and pumps it back into an artery. This type of ECMO provides support to the heart and lungs.
the VV ECMO drains desaturated venous blood from the patient, oxygenates the blood and pumps the blood back into a venous compartment. This type of ECMO provides support to the lungs only.
ECMO played an important role in treating patients affected by COVID-19 virus.
Dr. Robert Bartlett is known as the Father of ECMO for his pioneering work in developing ECMO.
The first ECMO was successfully used in 1972 in an adult patient with post-traumatic respiratory failure.
Ventricular Assisted Device (VAD) is an extracorporeal technique that is used to provide mechanical support to the patient heart.
There are different types of VAD:
Left, Right and bilateral VAD (BIVAD). This VADs can be temporary or permanent.
In this type of VAD the pump and the device controller is located outside the patient body. The pump is connected to the patient via cannulas. For the LVAD the cannulas are located in the left ventricle (drainage) and the aorta (return). For the RVAD the cannulas are located in the right ventricle (drainage) and the pulmonary artery (return).
In this VAD the pump is located inside the patient and the device controller out side the patient. The pump is connected into the left ventricle and a driveline will link the pump to the device controller.