ECMO is considered the last option when treating acute respiratory and heart failure. It was originally reserved for children predicted to have only a 20 percent chance of survival. Currently, cardiac ECMO is considered when a child's heart cannot pump enough to keep him alive. While some patients need ECMO before heart surgery, cardiac ECMO is mainly used after conventional cardiopulmonary bypass surgery either because a child cannot be weaned from bypass or because the child experiences clinical decline in the Intensive Care Unit after surgery. Cardiac ECMO may also be used for patients with:
Cardiac ECMO Selection Criteria
There are no generally accepted criteria for cardiac ECMO. The decision to proceed with ECMO is usually best made following an evaluation that includes echocardiography to rule out significant left over surgical problems. Development of secondary organ failure from low cardiac output or a sharp decline with cardiac arrest are other gauges for cardiac ECMO.
Many possible complications may occur when a child is treated with ECMO. Criteria have been developed to rule out those patients with symptoms that will worsen once ECMO has been started. Patients with poor quality of life expectancy due to a life-threatening symptom already present may also be ruled out. Your child's doctor can review specific exclusions with you if necessary.