Extracorporeal membrane oxygenation (ECMO) is a highly specialized respiratory treatment for newborns who are in the neonatal intensive care unit (NICU) with breathing problems. ECMO is a procedure that uses a special machine to take over the workload of the lungs, removing carbon dioxide (CO2) from the blood and adding in oxygen—just as the lungs normally would.

When a newborn has a respiratory condition that does not improve after receiving other treatments like inhaled nitric oxide, medicines or intubation and mechanical ventilation, the care team in the NICU may use ECMO. A child with pulmonary hypertension may receive extracorporeal membrane oxygenation treatment if these other less invasive treatments do not provide enough oxygen to the body.

While ECMO does not always cure the illness causing respiratory distress, it can stabilize your child’s condition. By reducing the strain put on the lungs, ECMO can give your child time to recover so that his or her doctors can provide other treatments for the underlying condition. For example, ECMO may be used to stabilize babies who have a congenital diaphragmatic hernia, so they can undergo surgical repair.

What to Expect

After trying other respiratory treatments, the Riley at IU Health NICU team may decide to start ECMO treatment. ECMO involves the use of a lung bypass machine, similar to the type of machine used on adults during heart surgery. However, it is set up to use for several days rather than several hours. For babies who are also having heart problems, ECMO can be set up to bypass the heart in addition to the lungs.

ECMO involves inserting one or more special tubes called cannulas into your baby’s blood vessels, normally at the neck or in the groin area at the top of the leg. There are two cannulas: one transports deoxygenated blood (blood that is not carrying oxygen), and the other transports oxygenated blood. In some cases, one single tube may contain both cannulas.

Using a combination of gravity and a special pump, one cannula moves deoxygenated blood out of the body and into a special machine that removes carbon dioxide and adds oxygen—just as the lungs normally do. The blood is warmed to body temperature throughout the process. Then the other cannula carries it back into your baby’s body where the heart can then circulate it and provide fresh oxygen to the body tissues. You may see these steps happening in the ECMO machine, which will be right next to your baby’s bed

Key Points to Remember

Extracorporeal membrane oxygenation (ECMO) is a highly specialized respiratory treatment for babies in the NICU.
When a newborn has a respiratory condition that does not improve after receiving other treatments, the care team in the NICU may use ECMO.
ECMO may be used as a treatment or to stabilize your baby before undergoing other treatments or surgery.
ECMO involves the insertion of one or more special tubes called cannulas that carry the blood to and from a machine that simulates the normal functions of the lungs.
In some cases, ECMO can act as both the lungs and the heart, helping to provide oxygen to the blood and pump it throughout the body.