Extracorporeal Membrane Oxygenation (ECMO) for Children

Extracorporeal membrane oxygenation (ECMO) — also known as heart-lung bypass — uses a machine to temporarily do the work of your child’s heart and/or lungs when they are fighting an underlying heart or lung condition. ECMO allows the heart and/or lungs to rest and heal. 

Remarkable Care for Kids

  • Advanced care for kids in critical condition: When your child is on ECMO in the pediatric intensive and critical care unit (PICU) at Rush, a team of pediatric critical care specialists will work closely with you and each other to constantly monitor your child and adjust treatment as your child’s condition requires.
  • Academic medical center expertise: At Rush University Children’s Hospital, you have access to more than 100 pediatric physicians and specialists — including pediatric surgeons, pediatric cardiologists and pediatric pulmonologists who all specialize in treating children on ECMO, as well as their underlying heart or lung problems.
  • Center of excellence: The Extracorporeal Life Support Organization recognized Rush as a Center of Excellence in ECMO services. This designation recognizes the exceptional ECMO care available at Rush.
  • A kid-friendly inpatient experience: Even while sedated, your child can hear sounds and may be calmed by a gentle touch. Child life specialists at Rush can help you find ways to comfort your child while they are on ECMO.

What is ECMO?

To begin ECMO, a pediatric surgeon will insert plastic tubing into your child’s blood vessels in the neck, groin or heart. This tubing connects your child to the ECMO machine. The machine will pump blood out and then back to your child as it does its work.

Types of ECMO

  • Venovenous ECMO supports the lungs. The ECMO machine removes carbon dioxide from the blood and adds oxygen to the blood. These functions are normally performed by the lungs.
  • Venoarterial ECMO supports both the lungs and heart. The ECMO machine removes carbon dioxide and adds oxygen to the blood, as healthy lungs would. It also takes over for the heart by pumping blood so it can get to other organs, such as the brain, kidney and liver.

Conditions that may require your child to need ECMO

ECMO is used in children who have temporary breathing or heart problems, such as in the following situations:

  • Meconium aspiration syndrome: A newborn may inhale meconium (their first stool) before or during delivery, which can cause lung problems.
  • Persistent pulmonary hypertension of the newborn: A newborn may not adapt properly to breathing outside of the uterus, causing high blood pressure in their lungs.
  • Congenital diaphragmatic hernia: A birth defect where part of the stomach or intestines stick out of a baby’s chest, causing pressure on the lungs.
  • Respiratory distress syndrome: A condition that often occurs in premature babies that makes breathing on their own difficult.
  • Pneumonia: A lung infection that may cause difficulty breathing in children of all ages.
  • Congenital heart defects: ECMO may be used before or after surgery to repair a heart problem present at birth.
  • Transplantation: ECMO may help support a child waiting for a heart or lung transplant.

Medications while on ECMO

Your child will receive the following types of medications while on ECMO:

  • Heparin: To help your child’s blood flow through the ECMO machine, your child will receive Heparin, a medication to stop their blood from clotting.
  • Sedation: Your child will receive medication to prevent pain and movement. This keeps your child comfortable while on ECMO and helps the machine work properly.
  • Nutrition: Since your child cannot eat or drink while on ECMO, your child will receive liquid nutrition through an intravenous line or feeding tube.

How long will my child be on ECMO?

Your child may be on ECMO for several days or several weeks. It depends on how long your child’s heart and lungs need to rest and recover.

Your child’s care team will work with you and each other to constantly monitor your child while on ECMO. As your child’s health improves, the ECMO specialist will lower the machine’s settings. This will allow your child’s heart and lungs to begin functioning on their own.

When your child’s heart and lungs can function on their own, the care team will disconnect your child from the ECMO machine. A pediatric surgeon will surgically remove the tubing that connected your child to the ECMO machine.