ECMO

This machine maintains blood flow and oxygen to vital organs. Small plastic tubes are inserted into a vein to draw out blood, and another tube is inserted into a vein or artery to return oxygenated blood. Your child’s surgeon chooses the size of the tubes based on their size, age and weight. The cannulas transfer blood from the patient’s body by using a pump to push the blood through tubes to the machine. Inside the machine, the blood receives oxygen and the carbon dioxide is removed. Then, the blood is warmed to body temperature. Finally, the warm blood goes through another cannula back to your child’s body. The ECMO is doing the work of your child’s heart and lungs.

Your child receives 24/7 monitoring and care, including:

• Bed bath: Your child will be given a gentle bed bath as often as needed. Depending on your child’s condition, you may help bathe your child.
• Food and nutrition: While receiving ECMO therapy, your child will be seen by a dietitian with specialized training in critical care nutrition. Your child’s care team makes sure they receive all the necessary nutrition, including vitamins, minerals and electrolytes, through an IV catheter or feeding tube.
• Lab testing: Your child’s care team will collect blood samples from the catheters that have already been put into place.
• Lung percussion: A respiratory therapist will be part of your child’s care team. They may gently press on your child’s chest to loosen any thick secretions. This will help your child’s lungs to heal.
• Medications: A critical care pharmacist is on our care team to provide various medications for children while they are receiving ECMO therapy.
• Positioning: The way your child’s body is positioned will help their lungs to heal. Your child’s physical therapist and care team will decide which position is best for your child.
• Procedures: Sometimes children receiving ECMO therapy need another medical procedure. Your child’s ECMO care team works closely with your child’s other specialists to provide the care your child needs.
• Ultrasound: Some children receiving ECMO therapy may need to have ultrasounds of their head to make sure there is not any bleeding inside the brain. Your child may also need an ultrasound or echocardiogram of their heart.
• Weighing: Your child’s weight will determine what medications will be given and if they are getting too much fluid or not enough. Your child may be weighed every night.
• X-ray: Your child will have X-rays while they are receiving ECMO therapy, to make sure the tubes stay in the proper position and to allow the doctors to monitor your child’s lungs.

Talk with your child life specialist: Your family can receive support from a child life specialist at Peyton Manning Children’s Hospital. A child life specialist can help explain the treatment to young siblings, provide support for the entire family, and help your family cope with having a child who is critically ill in the hospital.

Provide a healing environment: Hearing your voice and feeling your touch can help comfort your child. You can bring your child’s favorite stuffed animal or toy to the hospital. You can even make recordings of your family’s voices or music to play when you are not able to be with your child. Talk with your child’s doctor or nurse about what might be recommended for your child.