When ECMO is needed

Educational, not medical advice. ECMO decisions are individualized. If you have an urgent concern, call your physician or 911.

Module 3 — Delivery and the NICU · Episode 12

What ECMO is

ECMO (extracorporeal membrane oxygenation) is a heart-lung bypass machine that temporarily does the work of the lungs, and sometimes the heart, so they can rest and recover. Blood is drawn from the body, given oxygen by the machine, and returned.

When it is used

ECMO is reserved for the most severe situations, when breathing support and medicines are no longer enough to keep oxygen and circulation safe. Needing ECMO reflects how severe the disease is. Roughly a portion of CDH babies, more often those with the most underdeveloped lungs, require it.

Surgery and ECMO

When a baby is on ECMO, the timing of the diaphragm repair is an important decision. At Texas Children’s, the approach is to perform the CDH repair early, within about 24 hours of starting ECMO. Early repair on ECMO has been associated in the literature with better survival, less bleeding, and shorter time on the machine compared with waiting. Because ECMO involves blood thinners, the team uses specific protocols to manage bleeding risk around surgery.

What to expect

ECMO is intensive and closely monitored. The goal is to support the baby through the most fragile period and then wean off the machine as the lungs recover.

Next in Module 3: Why oxygen numbers don’t tell the whole story · Back to Module 3