Extracorporeal Membrane Oxygenation (ECMO)

Description of Services

The Extracorporeal Membrane Oxygenation (ECMO) service is part of the Perfusion Services Department and the Division of Pediatric Cardiothoracic Surgery. Medical direction of ECMO services is a combined effort closely coordinated among Cardiothoracic Surgery, Pediatric Critical Care Medicine and Pediatric Surgery.

The ECMO program has supported patients with complex heart and lung problems since 1979. Children’s ECMO expertise was recognized with an “Excellence in Life Support Award” in October 2009 from the Extracorporeal Life Support Organization.

Following referral and transport, patients are placed on ECMO support when the need is indicated and are cared for jointly by Critical Care Medicine and appropriate surgical staff. Following a period of ECMO support, patients are returned to the referring physician as soon as medically feasible. Provisions exist for routine simultaneous support of multiple patients. A large group of specially trained ECMO technicians is available for continuous bedside perfusion management. Linear post-ECMO follow-up is an integral part of the service.

Helping Both Heart and Lungs

When the heart and lungs are too weak to provide oxygen to the body, ECMO can help by oxygenating the blood and helping to circulate blood. In this way, the heart and lungs can rest and recover. ECMO is short for extracorporeal membrane oxygenation. Children can be on ECMO for a matter of days or several weeks.

ECMO support is offered to:

  • infants, children, and young adults with various kinds of respiratory distress
  • children requiring mechanical support during resuscitation from cardiac arrest
  • infants and children with cardiac decompensation secondary to viral myocarditis or cardiomyopathy who are awaiting transplantation
  • infants with respiratory distress secondary to a congenital diaphragmatic hernia

The Heart Institute at Children’s Hospital of Pittsburgh of UPMC has the facilities and equipment to provide support for four simultaneous ECMO cases, and about 45 procedures are done each year.

ECMO Transport

In 2008 Children’s became one of a handful of pediatric hospitals across the country to offer ECMO transport for children with failing hearts. Since then, patients have been brought to the hospital on ECMO from cities including Washington, D.C., Buffalo, N.Y., and Richmond, Va.

Patients who are transported on ECMO may be candidates for a heart transplant or for longer term cardiac support with a ventricular assist device — both of which are available at Children’s. The mode of transport used for ECMO patients — helicopter, fixed-wing plane, or ambulance — depends largely on the weather.

The ECMO transport team consists of five people — a doctor from Children’s pediatric intensive care unit, a nurse, a respiratory therapist, a perfusionist, and an ECMO technician.

From the time the team arrives at the patient’s bedside to when they transfer the patient into the helicopter or ambulance, the process takes about 2½ hours. The entire transport time — from leaving the hospital to returning with the patient — is usually about 12½ hours.

Referral Requirements

Referrals to the ECMO program at Children’s Hospital are usually directed through Children’s critical care physicians and through the hospital’s various intensive care units. Rapid medical transportation to the hospital can be provided, and the referral base for ECMO extends beyond western Pennsylvania to the New England states, the Midwest and the upper southern states.

For more information about ECMO services at Children's Hospital, please contact Pefusion Services at 412-692-5218.

To make a referral for mechanical circulatory support for respiratory or cardiovascular failure, please call 412-692-5540.

For critical care specialty transport, referring physicians may contact Children's ECMO transport team 24 hours a day, 7 days a week at 1-877-PEDS-HRT (733-7478).