ECMO is a device called Extracorporeal membrane oxygenation.It is sometimes used mainly to assist breathing when the heart and lungs do not have sufficient functions to sustain life, such as in patients with severe respiratory failure or severe heart failure.
ECMO removes venous blood (blood returning to the heart) that is deficient in oxygen from the patient's body through a tube (bleeding), sends it to the ECMO oxygenator with a pump, and removes carbon dioxide from the blood. It is a device that supplements the function of the lungs by removing the oxygen and adding oxygen instead (oxygenation) and returning the oxygen-rich blood to the body (blood supply). By using ECMO, you can create a situation where you can live without using your lungs at all (Lung Rest). ECMO is not a device used for treatment to directly treat and improve the lungs, but a device that supports breathing (lungs) and circulation (heart) while the lungs recover on their own.
VV-ECMO refers to returning (transmitting) blood that has been oxygenated (oxygenated) by ECMO to the veins of the patient going to the heart. is called VA-ECMO. VV-ECMO only has the function of assisting breathing, but VA-ECMO can assist the heart in pushing blood out in addition to assisting breathing.
ECMO began to be used for patients infected with COVID-19 (coronavirus) from around February 2020.It has been reported in China that it has been used as an adjuvant therapy for patients with acute viral pneumonia and reduced the mortality rate of severely ill patients by about 2%.However, if you have been performing high-pressure artificial respiration with a respirator for more than 3 days before putting on ECMO, there is a possibility that your lungs have suffered an irreversible damage that cannot return to their original state, so ECMO should be used. It is known that the prognosis is very poor even if it is applied.
Conditions in which ECMO cannot be used include (65) irreversible underlying disease, (75) terminal cancer, etc., and the prognosis is poor in those with chronic organ failure such as chronic heart failure or chronic respiratory failure, or in those aged XNUMX to XNUMX years or older. is generally said to be off-label.I think that it is not applicable to patients and elderly people who have decreased organ function due to chronic diseases, and it is necessary to keep infection prevention in mind.
