Extracorporeal membrane oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO) therapy, also called extracorporeal life support, is a life-saving device that can temporarily replace heart and lung function. It circulates blood, adding oxygen and removing carbon dioxide, before returning it to the body. Some people may need ECMO for a few hours, while others may need it for days or weeks. As you recover, the machine can gradually reduce its support, allowing your body’s natural functions to resume.

Penn Medicine performs more ECMO procedures than any other institution on the East Coast. We’re the only hospital in the area with a mobile ECMO program, allowing us to treat people who are too ill to travel from other hospitals.

There are two main types of ECMO treatment:

• Veno-venous (VV) ECMO: This type of treatment supports the lungs only. VV ECMO drains blood from the venous system or network of veins, returns it to the venous system, and provides oxygen while removing carbon dioxide to mimic the natural function of the lungs.
• Veno-arterial (VA) ECMO: This treatment supports both the lungs and the heart. VA ECMO drains blood from the venous system and returns it to the arterial system—the blood vessels or arteries that carry oxygenated blood away from the heart to the rest of the body.

You may be a candidate for ECMO treatment if you have a life-threatening condition affecting your heart or lungs, such as severe pneumonia, respiratory failure, heart attack, or pulmonary embolism. ECMO can provide temporary support to your vital organs, allowing your body time to heal.

We also use ECMO as a bridge for patients awaiting a lung transplant, heart transplant, or heart assist device transplant.

Being placed on ECMO requires a surgical procedure. A cardiothoracic surgeon inserts tubes into a blood vessel, usually in the neck or groin. These tubes connect to the ECMO machine, which pumps blood out of your body, adds oxygen, removes carbon dioxide, and then returns the oxygenated blood to your body.

While on ECMO, your heart continues to beat, but it doesn’t have to work as hard. A ventilator may be used to help with breathing, but in some cases, this can be avoided. Our team closely monitors your condition and adjusts the ECMO settings as needed.

After ECMO, you may need to stay in the ICU on a ventilator until your heart and lungs are strong enough to function independently. Once you can breathe on your own, eat without difficulty, and have stable vital signs, you may be discharged.

ECMO recovery time varies depending on your condition, but it typically takes several days or weeks.

People who need ECMO therapy are often quite ill and may already be facing significant health challenges. While ECMO can be a life-saving treatment, it’s important to be aware of the potential side effects. These can include:

• Bleeding
• Kidney problems
• Infection
• Stroke
• Blood clot in the lungs

Our ECMO specialists are cardiothoracic surgeons who work closely with ICU physicians and nurses, perfusionists (who operate machines), respiratory therapists, dietitians, social workers, and physical therapists to provide you with the highest quality care.

We’re leaders in the field. Our highly trained ECMO team includes prominent experts with national and international reputations. Team members undergo rigorous training so they can deliver advanced heart and lung support.

We’ve received recognition for excellence in ECMO care. Penn Medicine’s Penn Presbyterian Medical Center was awarded the Gold Level Center of Excellence award from the Extracorporeal Life Support Organization (ELSO).