Extracorporeal Membrane Oxygenation | ECMO | ECLS

The Risks & Complications of ECMO/ECLS

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.
It is 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.