Risks and Complications
ECMO is an extreme life-saving procedure. While ECMO can provide great
benefits, it is not without risk. The doctor will discuss all of the possible complications of ECMO with
you before the cannulas are placed, but several of the most common risks are listed below for you to
review. Although these and other complications (problems) are possible for any patient on ECMO, please
be assured that the ECMO team takes every possible safety measure to decrease these risks. Your loved
one and the ECMO machine will be monitored closely, 24 hours a day, by a well-trained team to help
prevent these problems from occurring and to keep your him/her safe. If a complication does arise, the
ECMO team will discuss the issue with you and consider the best plan for your loved one.
The most common complication of ECMO is bleeding.
This is because a medication called heparin is pumped into the ECMO circuit to prevent blood clots from
forming. Heparin does this by thinning the blood that so clots are less likely to form. Most often,
bleeding occurs around the ECMO cannula sites, or other surgical sites on the body. However, it is
possible for bleeding to occur anywhere in the body while a patient is on heparin. The most dangerous
bleeding may happen in or around the brain. Therefore, the ECMO team is constantly monitoring and
assessing for signs of bleeding.
also possible for any part of the ECMO circuit to fail or rupture (break open). It is the
ECMO specialists' job to constantly watch the circuit and detect potential complications. If the
circuit fails or ruptures, the advanced technology specialists and ECMO specialists are specially
trained to respond right away to correct the problem. The patient must be taken off ECMO prior to
repairing or replacing the ECMO machine. During this time, your loved one will be given the support
needed until ECMO can be restarted.
Small blood clots or air bubbles could possibly enter the bloodstream of the ECMO
circuit. The ECMO team takes every possible measure to prevent clots or air from reaching the
patient, which could cause a serious injury in the brain or lungs, called an embolism (em-bow-liz-em). A "bubble detector" is a safety device
that may be present on some circuits that stops the pump when a bubble is "seen" within the
tubing. This allows the ECMO specialist to remove the air before it reaches the patient.