Sometimes a person’s heart and lungs need help. In a healthy person, the heart pumps blood to the lungs, where the blood picks up oxygen. Then the bloodstream carries that oxygen to the rest of the body.

When the heart or lungs aren’t working right, doctors may need to support them with medications or a mechanical ventilator. When those treatments aren’t enough, ECMO can help.

No. ECMO will not cure the injured heart or lungs. It can support them for treatment and healing.

The ECMO team places tubes in some of the largest blood vessels in the patient’s body, in the neck, chest or groin.

One tube takes blood from the patient to the ECMO machine. Another tube returns the blood to the patient. The blood is warmed to body temperature before it goes back.

People on ECMO are also often on ventilators.

ECMO uses equipment that may look and sound strange or scary. Our team can tell you what each part does.

We may also give:

• Medication to lower the risk of blood clots.
• Blood products.
• Antibiotics, to treat infection.
• Sedatives, for comfort.

ECMO may affect a patient’s ability to talk because:

• They may have a tube in their mouth or throat that connects to a ventilator to help them breathe.
• The medications that help keep them comfortable may make them sleepy and less likely to interact.

Some people may be awake and off the ventilator. It is more likely that they can talk and interact with visitors and the health care team.

People on ECMO have feeding or IV tubes. They typically can’t eat or drink.

No. We place the tubes while the patient is under anesthesia. Patients also get pain medication and sedatives to help them relax or sleep. If they’re awake, they may not feel any discomfort.

If an ECMO patient is uncomfortable, we want to know right away.

• If the person is awake and interacting, they may be able to communicate their comfort level.
• With people who are sleepy or sedated, our health care team is trained to look for signs of discomfort, including facial expressions, heart rate and blood pressure.

We can increase comfort by moving the person into a new position or offering medications.

That depends on the person’s condition. Some people stay on ECMO a few days. Other people need it longer.

As a person’s heart and lungs recover, ECMO support is gradually reduced. Once the patient recovers, we withdraw ECMO.

People on ECMO are in a hospital’s ICU. At OHSU, someone on ECMO may be in our medical, cardiac or trauma ICU.

Our care teams include specialists in:

• ECMO
• Intensive care
• Palliative care, to relieve symptoms and anxiety
• Cardiology (heart care)
• Surgery
• Nephrology (kidney care)
• Infectious diseases

Patients and their loved ones also have access to:

• Social workers, who can help with meals, transportation or finding a place to stay.
• Chaplains, for spiritual support.

We provide daily updates on patients’ conditions. We also answer questions in person or by phone.

Risk of bleeding: Some bleeding is normal. If someone bleeds too much, we may transfuse blood products or perform surgery.

Risk of blood clots or stroke: Sometimes a clot or air bubble gets into the blood of a person on ECMO. We may give blood thinners (like heparin) to prevent clots. Sometimes a person on blood thinners will have bleeding in the brain, which can cause a stroke. We check each ECMO patient’s blood and central nervous system regularly.

Risk of infection: We may give antibiotics to treat infection.

Possible problems with the ECMO machine: All ECMO team members at OHSU have safety and emergency training.

ECMO might not work or might cause serious complications: A person’s heart and lungs might not recover fully. Their condition could get worse. They may have uncontrolled bleeding or develop a life-threatening infection.

Sometimes ECMO keeps someone alive who would die without it. While a person is on ECMO, we will talk with you about chances for recovery and whether ECMO support should continue.

The equipment we use for ECMO limits the space we have for visitors in patient rooms. We don’t recommend staying overnight in a patient room. We can give you a list of nearby places to stay. Our health care team may make some exceptions.

If someone is at risk for infection, we may limit visits or physical contact.

If you can visit, you can:

• Hold their hand or touch them if physical contact is safe.
• Talk to them. Even if they can’t answer, hearing your voice can help.
• Watch movies, TV or videos together.
• Play music or sing.
• Listen to a podcast or audiobook together.

Many people on ECMO are given sedatives to keep them comfortable. They may seem to be sleeping and may not remember interacting with you. Our health care team can help you find meaningful ways to comfort them.