When your child needs very little help from the ECMO machine, a “trial-off” of the machine is done. The cannulas remain connected to the child until we are sure that he is able to do all the work with his heart and lungs. When your child is ready, the cannulas are removed from the neck by the surgeon. This requires surgery and your child receives pain medication and medicine to keep him from moving during the surgery. The surgery will be done in the ICU, as before. The surgeon slowly removes the cannulas and ties the vein and/or artery so that no blood leaks through them. This also prevents any small clots from being released into the bloodstream. Once the cannulas are taken out, your child may be able to wake up. He remains on the same kind of bed and breathing machine. The ventilator is still used to give support to the lungs even after ECMO. However, the amount of support is not as much as your child needed before ECMO. Also, the I.V. fluids are now going directly to the child. The arterial line also stays in place so very small amounts of blood can be drawn to see how your child is doing.
A dressing may be placed over the incision. The stitches stay in place for about five days and are then removed. A scar about two inches long will be left but this will fade and shrink as your child grows.
As your child's lungs heal, the oxygen level in the blood gets better and better. This lets us decrease the amount of work the ventilator is doing. Little by little your child will do all the work on his own until he can be taken off of the ventilator. Your child may require some extra oxygen after the ventilator is removed. This also decreases until finally no extra oxygen is needed at all.