How does ECMO procedure work during Covid-19 care – all you need to know

The device can take carbon dioxide out from the patient’s blood and then adds oxygen to it. Image: IE

As the second wave of Covid-19 has wreaked havoc in the country, many patients are facing an acute shortage of medical oxygen and ICU beds. In such a scenario, many cases of critical patients have surfaced where even oxygen support is failing. For such cases, mechanical ventilation that helps in maintaining oxygenation is being opted. This clinical intervention technique is called extracorporeal membrane oxygen (ECMO).

Doctors have been choosing this in extreme cases where ECMO plays the role of an artificial heart and pair of artificial lungs, which is outside the body. The device can take carbon dioxide out from the patient’s blood and then adds oxygen to it. Initially, it was built to help newborns and infants having respiratory distress syndrome or some cardiac abnormalities. Over the last five years, the technique has been used in adults widely.

In order to use the machine, a plastic tube is inserted into a large vein and/or artery via the neck, chest, or groin of the patient. With the help of this tube, the patient’s blood can flow out into an oxygenator where more oxygen is added and carbon dioxide is removed. Then a pump sends the oxygenated blood back to the patient’s body via a different tube. It is to note that the process is done at the same frequency as a human heart does.

ECMO for Covid-19 patients

There is no doubt that the Covid-19 infection infects the lungs and impacts it working, leading to pneumonia. Lungs in some cases are damaged to an extent where they are not able to get rid of carbon dioxide and the gas can then be passed on to the blood. Therefore, in Covid-19 cases with extensive damage, ECMO is being considered. A report by The IE noted that among Covid-19 patients, it can be beneficial in taking the load off the right side of the heart. Apart from this, the technique allows an increase in the oxygen level, thus reducing the pulmonary vascular resistance. This will take off pressure from lungs to push blood.

The report highlighted that the ECMO process can support patients’ bodies and give them some more time, as they battle with the deadly virus. To be sure, extra time is often needed in patients who are critical with the Covid-19 infection. Covid patients can stay on this treatment for 10-12 days. After ECMO is taken off, they are to be isolated in cardiovascular ICU.

To be sure, ECMO can also lead to a reduction in the chances of a cytokine storm. Cytokine storm is one of the reasons for many deaths in Covid-19 patients. During a cytokine storm, a patient’s immune system reacts on the patient itself and leads to severe inflammatory response and multiple organ failure.

ECMO risks among patients

Bleeding is a major concern for patients on ECMO. In order to go under this treatment, patients need to take blood-thinning medication, and sometimes when they are on ECMO, they can start bleeding at different places in their body. Acute renal failure is also a possibility while on ECMO. The report said that sometimes, patients can also get infected from tubes that have been put in.