Providing ECMO care to critically ill infants and children
The Children's Hospital of Richmond at VCU is one of the only hospitals in Central Virginia with the specialized team and equipment to provide life-saving extra-corporeal membrane oxygenation care to critically ill infants and children. We were one of the first member hospitals of the International Extracorporeal Life Support Organization.
Now patients and their loved ones have even more assurances that their children are in the best possible hands as we have received a prestigious Gold Level ELSO Award for Excellence in Life Support from the Extracorporeal Life Support Organization (ELSO).
What does ECMO stand for and what is it used for?
ECMO stands for extra-corporeal membrane oxygenation, which is a fancy way of saying that the treatment uses an artificial lung (oxygenator) to get oxygen to your child’s body and remove carbon dioxide, working like a healthy lung would.
When a child’s heart and lungs are too sick to function on their own, this treatment takes over, allowing time for other treatments to work and the body to heal. ECMO uses a pump to circulate the blood through the artificial lung and back into the bloodstream.
Care at the CHoR
We were one of the first member hospitals of the International Extracorporeal Life Support Organization and are the only gold-certified Center of Excellence in Central VA. This signifies that our team of doctors, nurses, ECMO specialists and perfusionists have the training, experience and expertise to care for infants and children who need this advanced cardiopulmonary life support.
Our dedicated ECMO team will monitor your child’s health around the clock while receiving the life-saving treatment.
- Dedicated team: Our pediatric ECMO specialists provide care 24/7.
- Routine monitoring: Our team of specialists will monitor your child’s vital signs, administer any medications and monitor the ECMO machine.
- Scans and testing: X-rays and blood tests will be done to check for any changes in the lungs or heart, ensuring your child receives the best care.
When is ECMO needed?
ECMO can help newborns and children with a variety of medical problems and conditions, including:
- Congenital heart disease
- Congenital diaphragmatic hernia (CDH)
- Persistent pulmonary hypertension
- Meconium aspiration syndrome
- Infection/Sepsis
- Pneumonia
- Near drowning
- Asthma
- Post-operative cardiac care
Support services for families with children on ECMO
We know that you will want to be involved in your child’s care, but don’t necessarily know what to expect during this time. Know that we are here for you, every step of the way. We offer a variety of support services to help your family navigate this difficult time.
ECMO frequently asked questions
How does the ECMO machine work?
The ECMO machine consists primarily of two parts: a pump, and a circuit made up of a membrane (artificial lung), a blood warmer and a filter.
The machine removes blood without oxygen (also called blue blood), from your child and pumps it through the membrane where it receives oxygen and becomes red, warm and filtered. The blood is then returned to your child safely.
ECMO can be used to support:
- Heart and lung function (Veno-arterial ECMO)
- Lung function (Veno-venous ECMO)
Veno-arterial (VA) ECMO is when blood is drained from a vein and returned to an artery which transports the oxygenated blood to organs and other body tissues where it is needed.
Veno-venous (VV) ECMO is used to support lung function by draining blood from the vein, oxygenating it and then returning it to the vein, where it is pumped through the heart to arteries that carry the oxygenated blood to organs and other body tissues.
Does ECMO hurt?
Patients do not generally feel pain when on ECMO and receive pain medications and sedatives. You will be able to talk to and be with your child while they are receiving ECMO.
How long can my child be on ECMO support?
The time frame can vary by child, but the average is a week. It is generally continued until the underlying problem with the heart or lung is resolved so in some cases it can take longer.
Your child’s progress will be monitored using x-rays, blood tests and echocardiography (ultrasound). Only with careful evaluation of the lungs and heart, and the ability to function with minimal to no support, will ECMO be discontinued.
If the doctor determines that the lungs and/or heart can function without support, it will be reduced gradually. The gradual schedule helps make sure the lungs are supplying the right amount of oxygen and the heart is effectively pumping. During this time, your child’s oxygen and carbon dioxide levels will be checked.
Are there any complications with ECMO?
Bleeding is the most common complication associated with ECMO. This is because a blood thinning medicine is continuously administered to prevent blood clots and keep the ECMO circuit flowing.
The level of blood is monitored every hour and the goal is to minimize the use of this blood thinner and reduce the bleeding.
All vital organs are routinely monitored with blood tests, ultrasounds and other examinations to ensure that there is a steady support system for you child. All ECMO specialists at CHoR are trained to manage any related emergencies.
Can I still breastfeed if my child is on ECMO?
We encourage you to pump your breasts and store the milk during this time. Our on-site lactation specialists can provide support as needed. We also offer private lactation rooms if you prefer privacy.
What can I do while my child is on ECMO?
Being in the room with your child, so they know you are there to support them, is probably the most important thing you can do as a parent or guardian. We know it is a scary time for your child, so hearing your voice and knowing you’re there is helpful.
What are the chances of survival after ECMO?
We offer ECMO support to those who have high chances of a healthy recovery. Our team is one of the most experienced in the region, identified as a gold Center of Excellence by the Extracorporeal Life Support Organization.
