Pediatric ECMO (Extracorporeal Membrane Oxygenation)

Extracorporeal membrane oxygenation (ECMO) is an advanced life support technique used when a patient has a life-threatening problem with their heart or lungs. This system, which is an artificial lung machine kept outside of the body that gets oxygen to the blood, allows the weakened heart and lungs to rest while doctors work to treat the underlying cause of the illness.

At NewYork-Presbyterian Komansky Children’s Hospital, our ECMO team of critical care physicians, neonatologists (newborn care specialists), surgeons, cardiologists, nurses and nurse practitioners, perfusionists, respiratory therapists, neurologists, palliative care specialists, social workers, physical and occupational therapists, skin care specialists, and child life specialists collaborate to provide the most advanced care in a setting that is comfortable for your child and is family-friendly.

Our ECMO service, which is available in the Pediatric Intensive Care Unit (PICU) or the Neonatal Intensive Care Unit (NICU), uses the latest technology and therapies available to offer critically-ill children and infants the best chance for survival with a good quality of life.

Does My Child Need ECMO?

We use ECMO to treat children who are not doing well with conventional medical treatment and who would probably not survive without this therapy. This includes those with:

  • meconium aspiration syndrome (newborns)
  • heart failure
  • acute respiratory distress syndrome
  • pulmonary hypertension
  • congenital diaphragmatic hernia
  • cardiomyopathy
  • myocarditis
  • sepsis
  • pneumonia
  • other life-threatening conditions.

We also use ECMO in some children awaiting a heart or lung transplant.

How is ECMO Performed?

Normally when your child breathes, his/her lungs provide oxygen to the blood and carbon dioxide is removed. The heart pumps well-oxygenated blood to your child’s entire body. For children who have a severe illness involving their heart or lungs, ECMO, which is performed using a heart-lung bypass machine, works as an "artificial heart and lung" — removing carbon dioxide from your child's blood outside the body and delivering oxygenated blood to the body. This allows these organs heal.

A surgeon will place one or more plastic tubes through large blood vessels in your child's neck, leg, or chest. Your child will receive pain medication and sedation, as well as other medications to ensure his or her comfort. Depending on your child's condition and needs, we will use one of two ECMO approaches:

  • Venovenous (VV) ECMO, which we use when the heart is working well but the lungs need time to rest and heal.
  • Venoarterial (VA) ECMO, which we use when the heart and/or the lungs need support as well as time to rest and heal.

What Should I Expect When My Child Receives ECMO?

  • Nutrition: We will discuss with you the most appropriate choice of nutrition for your child during ECMO treatment. Your child may receive nutrition intravenously (by vein) or through a tube similar to a nasogastric tube.
  • Comfort: Your child will receive medication to relieve pain or discomfort. The circulation of blood through the ECMO machine is not painful.
  • Touch: You will be able to touch and talk to your child. In fact, your familiar voice and face and the comfort of your touch are extremely helpful and nurturing during your child's care.
  • Length of Treatment: Your child may be on ECMO for a few days to a few weeks, depending on the severity of his or her heart and lung problems. We will keep you posted several times each day on how your child is doing during ECMO therapy.

Referrals and Transfers For Pediatric ECMO

Doctors who wish to transfer a pediatric or newborn patient to our center can call us, 24/7, at 1-800-NYP-STAT (1-800-697-7828). Our team will assess your case and facilitate a timely transport of your patient or dispatch our highly skilled Mobile ECMO Transport Team when appropriate. The team's ambulance has advanced equipment, such as a portable ECMO machine, and specially trained paramedics. Working with other members of the transport team — including the intensive care physician, ECMO surgeon, and perfusionist — we bring the services of an intensive care unit to patients to provide the safest possible transport to our hospital.


Pediatric Surgery
NewYork-Presbyterian Komansky Children's Hospital


Physicians Seeking to Transfer a Patient

800-NYP-STAT (800-697-7828)