Skip to main content

8110 Gatehouse Road, Falls Church, VA 22042

Extracorporeal Membrane Oxygenation (ECMO)

The Extracorporeal Membrane Oxygenation (ECMO) Program at Inova Heart and Vascular Institute and Inova Children’s Hospital provides life-saving support to adults, children and neonates with severe cardiac or respiratory failure.

What is ECMO?

ECMO is a modified form of cardiopulmonary bypass which can provide temporary support of lungs and heart to patients who are failing conventional treatments. It is a form of advanced life support used for patients who are critically ill.

ECMO does not cure underlying disease. It provides time for the patient to recover, or potentially be bridged to a long-term support device, receive a transplant, or for the family and team to make decisions about their loved one’s future.

 

Patients Who Benefit from ECMO

The ECMO program at Inova Heart and Vascular Institute has supported patients with a variety of illnesses and conditions:

  • Cardiac arrest and/or myocardial infarction
  • Heart failure / patients awaiting heart transplant
  • Lung failure 
  • Blood clots in the lung / pulmonary embolus
  • Pneumonia
  • Influenza
  • Postoperative heart surgery
  • Shock from infection
  • Trauma
  • Heat stroke
  • Poisoning
  • Poor oxygenation (from newborns to adults) such as lung failure from pneumonia, cystic fibrosis, and chronic lung disease

"Awake and Walking ECMO"

The Inova team pioneered "awake and walking ECMO," allowing patients to be mobile when usually they are sedated under life support. This is beneficial to the patient as it results in more stable circulation, stimulation of spontaneous breathing, a larger quantity of air inhaled, and communication with the staff and family.

Inova is Ready for ECMO Patient Transfers

Our integrated EPIC electronic medical record allows other Inova hospitals to help identify and transfer patients. Inova can also provide transport for patients from other hospitals. In addition to patients in immediate need of ECMO support, eligible patients may also include those already receiving support who need to be transferred to a larger center for transplant consideration or other reasons.

Referrals for ECMO Treatment

To speak with a specialist about an ECMO referral, please call Inova's Cardiac Access line at 703-776-5905. To learn more about the Inova Children's Hospital ECMO program, visit inovachildrens.org/ecmo. To transfer a patient using the Inova Children's Hospital Ambulance and One Call Transport, please call 1-877-900-9543.

Inova Heart and Vascular Institute Experience

The Inova Heart and Vascular Institute facility on the Inova Fairfax Medical Campus houses our ECMO program.

Referrals from centers throughout the Mid-Atlantic region have been transported to Inova for, or even on, ECMO support. Inova Heart and Vascular Institute’s capabilities cover the full spectrum of complex cardiovascular and pulmonary care.

Inova’s expansion of ECMO from support of postoperative cardiac patients began in 2016. The program now encompasses over 41,000 hours of support to critically ill children and adults. In 2018, 83 patients were supported with ECMO, and in 2019 we are on pace to support over 100 patients.

Conditions Treated by ECMO

The ECMO program at Inova Heart and Vascular Institute has supported patients with a variety of illnesses and conditions:

  • Cardiac arrest and/or myocardial infarction
  • Heart failure/patients awaiting heart transplant
  • Lung failure
  • Blood clots in the lung/pulmonary embolus
  • Pneumonia
  • Influenza
  • Postoperative heart surgery
  • Shock from infection
  • Trauma
  • Heat stroke
  • Poisoning
  • Poor oxygenation (from newborns to adults) such as lung failure from pneumonia, cystic fibrosis, and chronic lung disease

Inova's ECMO Team

ECMO requires multidisciplinary team support and many services contribute to offer premium care to these special patients at Inova. Specialists include:

  • Critical care physicians/intensivists
  • Critical care nurses
  • ECMO specialist
  • Cardiac surgeons
  • Perfusionist
  • Clinical pharmacist
  • Cardiologists
  • Pulmonologists
  • Lung and heart transplant physicians
  • Infectious disease physicians
  • Nephrologists
  • Respiratory therapists
  • Physical and occupational therapists
  • Speech therapists
  • Neuro critical care physicians
  • Social workers
  • Neonatologists
  • Pediatric critical care
  • Vascular surgeons
  • Interventional radiology

ECMO Team Leaders

How Does ECMO Work?

 

The ECMO device is connected to a patient through plastic tubes (cannula), which are placed in large veins and arteries in the legs, neck or chest.

It replaces the function of the patient's lungs by drawing blood from the body to a pump, which then pushes the blood through an artificial lung (oxygenator). The oxygenator adds oxygen to the blood and removes carbon dioxide. The ECMO machine then acts like the heart, sending blood back to the patient.

Risks of ECMO

There are potential complications that are associated with being on ECMO:

  • Blood Clots: Blood can clot within the ECMO machine, the tubes, and in the patient – resulting in a need to change out the circuit, momentarily causing a loss of support. Loss of blood flow can develop in the arms or legs, requiring procedures to improve blood flow, or in rare cases, result in the need for amputation.
  • Bleeding: To prevent clots, patients will receive blood thinners increasing the risk of bleeding at incision and insertion sites, in other wounds, and in other organs, such as the brain. The care team monitors effects of medications on the patient to ensure that there is a balance between giving enough medication to prevent blood clots while not increasing the risk of bleeding. However, there is no way to completely eliminate this risk.
  • Infection: Patients on ECMO are also at high risk of developing an infection or pneumonia.
  • Weakness: Patients on ECMO long term can become very weak and require longer, aggressive physical therapy.
  • Mechanical Problems: As the ECMO circuit is a machine, mechanical problems can arise. The ECMO Specialist and Perfusion Team are available 24/7 to help monitor and assist.