nicu baby holding pediatric nurse's hand

ECMO stands for extracorporeal membrane oxygenation, a procedure in which a machine outside of the body takes over the work of your child’s heart and/or lungs to allow them to rest and heal.

The machine is connected to the patient’s body by a catheter (tube) inserted during surgery through the arteries and veins of the neck area in infants, the groin area in children, or the chest area following cardiac surgery. Your child will be given medications during surgery to prevent pain and movement.

Your child will also have a breathing tube inserted through his nose or mouth that is connected to a ventilator, which is needed to prevent his lungs from collapsing while they heal.

What conditions can be treated using ECMO?

  • Persistent pulmonary hypertension of newborn
  • Meconium aspiration syndrome
  • Congenital diaphragmatic hernia
  • Air leak syndrome
  • Pneumonia
  • Acute respiratory failure
  • Post trauma
  • Severe asthma attacks that don’t respond to other therapies
  • Aspiration syndromes from a foreign body, hydrocarbons or water from near drowning
  • Myocarditis
  • Cardiomyopathy
  • Failure to wean from cardiopulmonary bypass following heart surgery
  • Extracorporeal cardiopulmonary resuscitation (ECPR)
  • Arrhythmia

At Children’s Healthcare of Atlanta, we have one of the few pediatric ECMO centers in the Southeast. We’ve been recognized as an ECMO Center of Excellence by the Extracorporeal Life Support Organization (ELSO)—the world’s premier ECMO organization—since 2007. This award is only for select centers that provide exceptional ECMO care, as evidenced by large numbers of children receiving ECMO (more than 1,100 patients since 1991), extensive training programs, constant review and use of teamwork to produce excellent outcomes.

Our multidisciplinary team of pediatric ECMO specialists, cardiac intensive care physicians, nurses and specially trained respiratory therapists provides customized ECMO care for every patient the team treats. Additionally, we perform ongoing research to improve the quality of care delivered to patients requiring ECMO and, ultimately, to reduce the need for ECMO.

Having a child who is critically ill and requires ECMO support can be overwhelming. The following FAQs are intended to help you better understand what to expect from ECMO procedures. If you have any further questions or concerns, don’t hesitate to discuss them with your child’s ECMO team at Children’s. We’re here to help.

The ECMO machine is made up of several parts: a pump, an artificial lung, a blood warmer and an arterial filter. It takes the blue blood (without oxygen) out of the right side of the heart and pumps it through the artificial lung (oxygenator). The blood is now red blood (with oxygen). This blood is warmed and filtered before it is returned to your child.

Parents and family members are encouraged to visit their child while he is on the ECMO machine. Although your child cannot be held by you while he is on ECMO, it is important that he knows you are there. Even the simplest forms of interaction are important to your child, such as talking to him, singing him a lullaby or holding his hand, whether he is awake or asleep.

For moms who are breastfeeding, we encourage you to pump and save the milk by freezing it for use after your child is off ECMO. Your nurse can give you more information on this. Your social worker may be able to help you locate an electric breast pump for rental and arrange a referral with a lactation counselor.

When your child’s body no longer needs ECMO, a surgeon will remove the tube that connects it to your child’s body. A ventilator, which is less intensive than ECMO, will be used to support your child’s heart and lungs after the ECMO support is removed. As your child’s lungs heal and the oxygen level in the blood gets better and better, the ventilator use will decrease until finally no extra oxygen is needed at all.

To go home, your child needs to be medically stable and gaining weight while on regular feedings. Many babies have difficulty swallowing after ECMO. If your child has these difficulties and is unable to take enough food, a tiny plastic tube will be placed through his nose or mouth into his stomach. Nurses and occupational therapists will help you learn the correct way to feed your child through the tube. Keep in mind that the feeding problems will probably go away with time and patience.

Although it may be frightening to take your child home from the hospital, this is a positive step. Feelings of anxiety, loneliness and uncertainty are normal. A period of adjustment is also normal. Be patient with yourself and your child.

In addition to your routine pediatric care, we highly recommend your child be seen in the Emory Developmental Continuity Program for follow-up care. This program identifies any special needs your child may have, helps you understand your child’s growth and development, and helps you find any services your child may need. All babies are offered this program. Older children are followed by their pediatricians who monitor them for medical, developmental, visual, speech and hearing needs.

In addition, we’ll want to see your child at the ECMO Center three and six months after discharge and again at one year and every year afterward. Extra visits may be scheduled depending on your child’s needs. We’ll give your child a physical and neurodevelopmental exam at every visit.