Extracorporeal Membrane Oxygenation. Extracorporeal means the blood circulates outside the body. Membrane oxygenation means that the ECMO machine helps deliver oxygen to the blood.
ECMO has been around for decades. The first successful use of ECMO in an adult occurred in 1971. NewYork-Presbyterian has had experience with ECMO since the 1980s.
The main goal of ECMO is to support the body — by delivering oxygen and removing excess carbon dioxide — when the lungs or heart are unable to do so. The ECMO machine takes over the work of the lungs and heart so the patient can recover or be bridged to transplant, another device, or surgery. ECMO may also be used by select patients with cardiac or respiratory failure.
The conditions we use ECMO for vary widely, but include severe pneumonia, severe forms of the acute respiratory distress syndrome (ARDS), severe asthma (status asthmaticus), pulmonary hypertensive crisis, massive pulmonary embolism (blood clot in the lungs), acute coronary syndrome (heart attack), acute decompensated heart failure, severe myocarditis, and post-cardiotomy shock (shock following open heart surgery).
At NewYork-Presbyterian, a dedicated team of ECMO clinicians including surgeons, critical care physicians, and nurse practitioners determine if a patient is eligible for ECMO. Each patient’s case is considered on an individual basis.
Every ECMO patient at NewYork-Presbyterian is cared for by a multidisciplinary team that may include thoracic or cardiac surgeons, critical care physicians, perfusionists (experts handling the ECMO machine), nurse practitioners, nurses, pharmacists, and physical and occupations therapists who have all been specially trained to care for ECMO patients.
The surgical cannulation usually occurs at the patient’s bedside or in the operating room. Our surgeons can place a patient on ECMO at a referring hospital and provide safe transport back to NewYork-Presbyterian/Columbia and NewYork-Presbyterian/Weill Cornell if the patient is too sick to travel without ECMO.
The length of time someone is on ECMO varies significantly based on the type and severity of the underlying illness, as well as factors like age and overall health status. On average a patient with an acute illness needs ECMO for 1 to 2 weeks.
ECMO is often considered a “rescue” or “salvage” method, when other medical treatments have failed. ECMO is usually considered an option for support only when other potentially lifesaving options are not adequate or appropriate.
No. ECMO support requires a multi-disciplinary team with specialized skills and experience. NewYork-Presbyterian is one of the most experienced hospitals in the world and has a comprehensive, specialized program dedicated to supporting patients with ECMO.
The NewYork-Presbyterian ECMO program transfers many patients from referring hospitals. When a referring hospital is treating a patient who might benefit from ECMO, the hospital can call our ECMO team at 1-800-NYP-STAT. The treating physician at the referring hospital and the ECMO team at NewYork-Presbyterian discuss the best options for the patient.
ECMO is a potentially life-saving, yet complex procedure and is not without risk. When a patient is sick enough to require ECMO, often the potential benefits outweighs the risks. Our team is skilled at minimizing the risks of ECMO whenever possible.
The NewYork-Presbyterian ECMO program is one of the most experienced in the country. Our team has been awarded Platinum Center of Excellence designation by ELSO (an international, non-profit consortium of health care institutions who are dedicated to the development and evaluation of novel ECLS therapies) since our program’s inception. We have published numerous scientific papers on our extensive experience with ECMO transport, as well as our innovative treatment methods and surgical approaches. We remain on the forefront of evolving ECMO techniques and technology, and our clinicians are asked to teach and speak about our ECMO experience throughout the world.
Our intensive care unit has an open visitation policy – families can visit throughout much of the day and night, except during emergencies and when the nurses are changing shift. We encourage family and friends to visit their loved ones throughout their ICU stay.
Many patients have been saved by ECMO when other treatments have failed, however ECMO is not a cure for the underlying illness. The goal with ECMO is to provide oxygen to the body until the lungs (or lungs and heart) recover. Effectively, the goal of ECMO is to buy time by supporting the patient during the most critically-ill period.
Our team has successfully used ECMO to support COVID-19 patients who are critically ill at NYP/CUIMC. A recent study demonstrates similar survival rates in ECMO patients with severe respiratory or cardiac failure due to COVID-19 as patients with severe respiratory or cardiac failure due to other reasons. Learn more here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32008-0/fulltext.
Clinicians, patients and families can email non-urgent questions to [email protected]. For referrals, physicians can call 1-800-NYP-STAT, 24/7.
At NYP we treat patients in need of ECMO regardless of insurance status, but for those without insurance, our social workers will work with you and your caregiver to help you obtain emergency Medicaid. In addition, there are payment plan options are available.