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If you have been reading the news, you might be well aware of the fact that Tamil Nadu CM Jayalalithaa's condition has worsened following a cardiac arrest. Jayalalithaa was admitted to Apollo Hospital on 22nd September this year following fever and dehydration. However, later she was treated for infection and respiratory problems following which she was recovering and was about to be discharged in few days. But after she has cardiac arrest late evening on 4th December, the 68-year-old politician was kept under ECMO as the heart and lungs are not functioning properly, according to the reports. So if you are wondering what is ECMO? How does it work? Who are advised to undergo the treatment? Our expert Dr Ashwin B Mehta Director of Cardiology, Jaslok Hospital & Research Centre, Mumbai answers some of the common queries on ECMO.
What is ECMO (Extra-Corporeal Membrane Oxygenation)?
ECMO is an assisted breathing technique which helps in providing oxygen to the body when the lungs and heart fail to function properly. It acts as a life support for patients when the lungs or the heart are unable to supply oxygen to the body. Read about signs that your heart is in trouble.
How does it work?
When the heart becomes weak or the pumping strength of the heart goes down, it is a sign that the patient might require an external support. This is the time when the venous blood which returns back to the heart is sucked out by the ECMO machine by a tube in the right heart. The ECMO makes the blood oxygenated, which is then pumped back into the body's circulation so that the heart is allowed to take rest. The oxygenated blood is supplied all the parts of the blood which accounts to pumping 2.5 litres to 3.5 litres of blood in a minute.
Does ECMO support only the heart function?
ECMO supports both the organs -- the heart and the lungs -- meaning neither the heart is required to pump and nor the lungs are required to oxygenate as ECMO has an oxygenator. This is the reason ECMO is called a membrane oxygenator. If the heart is very poor in action and is not able to meet body's demand or the lungs fail to work, then ECMO helps tremendously by acting as an additional support. This is done as and when the expert finds that the heart is able to return to its original status after the initial injury to the heart subsides.
When is it advised?
ECMO is advised whenever a patient has a serious yet reversible injury to the heart muscle. It is also recommended if a patient suffers from a serious injury to the lungs in which the lungs are not capable of functioning properly. For example, if the patient suffers from acute respiratory distress syndrome, a condition where the lung membrane thickens and the breathing surface of the lung is reduced, ECMO is advised. It is mostly useful when a doctor suspects an underlying condition is likely to improve by treatment or as natural evolution over time. Also know about signs that your LUNGS are in trouble!
If the result is indefinite meaning, the condition may not improve over time, than ECMO is not advised. For example, if a patient has a very poor heart function and has suddenly come to a stage of collapse, which requires a heart transplant. In such a case, ECMO helps you to carry on till you wait for a donor.
Are there any complications associated with ECMO?
There are two major complications associated with ECMO. Firstly, a patient undergoing ECMO has a tendency to bleed due to low platelet count. And secondly, the person is at a high risk of infection or sepsis following the treatment.
What are the survival chances?
The survival chances of a patient following an ECMO depends on the condition of the patient. If the patient is suffering from acute or reversible injury to the lungs or septic depression of the heart muscle, which is reversible, you can anticipate good results from ECMO. However, if the person is dealing with an end-stage disease, then ECMO may not be helpful.
For how long does a person need to be on ECMO?
There have been occasional cases when the patient has remained on ECMO for around two to three months. However, in most cases, ECMO-related problem are solved in about seven to 10 days.
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