Extracorporeal membrane oxygenation (ECMO) is the highest level of life support for people who are in cardiac or respiratory failure. It's a technology that works outside the body to pump and oxygenate a patient's blood. This allows the overworked heart and lungs to rest and heal.
At UC San Diego Health, we provide in-hospital ECMO as well as mobile ECMO.
We have a multidisciplinary team of physicians, nurses, pharmacists, occupational and physical therapists, respiratory therapists, and perfusionists who care for patients on ECMO while at UC San Diego Health. With this large team, we provide comprehensive care to give patients the best opportunity to recover.
Physical and Occupational Therapy
We also provide physical and occupational therapy for patients on ECMO when appropriate. Some patients on ECMO are even able to exercise and walk. This helps them maintain their strength as they recover or receive advanced therapies, such as ventricular assist devices or transplantation.
Some patients are too ill for transport to our center using conventional life support. In this case, our mobile ECMO team will place patients on ECMO at other hospitals and transport them back to UC San Diego Health.
Led by Travis Pollema, MD, Mazen Odish, MD, and Cassia Yi, APRN, CCRN, our mobile ECMO team uses a variety of transportation methods to transfer patients up to 300 miles away from our La Jolla campus.
UC San Diego Health is one of the few centers in Southern California that provides mobile ECMO.
Video: ECMO in Action
San Diego Union-Tribune produced this video that shows our ECMO team in action along with a patient who shares his life-saving experience. Length is just over 5 minutes.
Our ECMO Team
Our ECMO team represents many disciplines, including cardiothoracic surgery, nursing, pulmonology, cardiology, emergency medicine, anesthesiology, perfusion and pharmacy.
We have extensively trained a group of our intensive care nurses to take care of ECMO patients with support of our perfusionists who operate the heart-lung machine.
UC San Diego Health is designated as Magnet® Hospital by the American Nurses Credentialing Center (ANCC), which recognizes superior quality and innovation in nursing care.
Determines if a Patient Is Eligible for ECMO?
A dedicated team experienced in ECMO assess the whole patient to determine ECMO eligibility. This team includes surgeons, pulmonary and critical care physicians, cardiologists, and an ECMO nurse specialist.
What Conditions Can ECMO Therapy Help?
Respiratory failure, including causes such as:
Heart failure, including causes such as:
- Acute lung Injury such as acute respiratory distress syndrome (ARDS)
- Viral illnesses, including influenza or coronavirus
- Sepsis-related ARDS
- Pneumonia (viral, bacterial, atypical)
- Pancreatitis with systemic inflammatory response syndrome (SIRS)
- Burns (smoke inhalation)
- Failed lung transplant
- Bridge to lung transplant
- Acute or chronic heart failure
- Cardiogenic shock
- Acute myocardial infarction
- Refractory arrhythmias
- Post-partum cardiomyopathy
- Pulmonary embolus
- Post-cardiotomy failure (post-surgery)
- Post-transplant organ failure
- Hypothermic arrest
- Drug overdose
- Anaphylactic shock
- Failed heart transplant
- Bridge to ventricular assist device (VAD) or transplants
For Providers: Criteria for ECMO
- Refractory hypoxemic respiratory failure with a ratio of arterial oxygen tension to fraction of inspired oxygen (PaO2/FiO2) of <100 mmHg despite optimization of the ventilator
- Severe hypercapnic respiratory failure
- Improved outcomes if patients are placed on ECMO within 7 days of respiratory failure
- Pre-lung transplant rehabilitation
- Pulmonary support as a bridge to lung transplantation
- Cardiogenic or circulatory failure despite optimization of conventional therapies.
- Cardiac support as a bridge to recovery, ventricular assist devices, or heart transplant
- Massive pulmonary embolism requiring vasopressor support
- Failure to wean from cardiopulmonary bypass after cardiothoracic surgery
- Pre-existing condition that is incompatible with recovery (severe neurologic injury, end-stage malignancy)
- Uncontrollable bleeding