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Treatment at the Adult ECMO Program

At NYU Langone’s Adult ECMO Program, our team uses mechanical circulatory support and extracorporeal membrane oxygenation (ECMO) to take over the work of a person’s heart and lungs, allowing them to heal. Mechanical circulatory support and ECMO can help treat people experiencing cardiogenic shock related to heart failure or heart attack, or acute respiratory failure related to acute respiratory distress syndrome, lung failure, pneumonia, or influenza. These types of treatments can last a few hours or for up to a few weeks. Our medical team transitions your loved one from the treatment as soon as it is safe to do so.

There are two main types of ECMO devices: venoarterial ECMO that supports both the heart and lungs and venovenous ECMO that mainly supports the lungs. A mechanical circulatory support device provides support solely to the heart.

ECMO and other support devices are used after other remedies, such as medications, extra oxygen, or a mechanical ventilator, are insufficient to keep oxygenated blood circulating through the body. These treatments are initiated via a surgical procedure that requires anesthesia. The surgeon places plastic tubes called cannulas into blood vessels in the patient’s neck, chest, or leg. These tubes connect to the heart, transporting blood to the ECMO machine where it is enriched with oxygen and then returned to the body.

This care is provided by our Adult ECMO Program doctors, supported by Bridget Toy, BSN, RN, program manager, and Frederick Hill, RN, CCP, the director of perfusion.

Mechanical Circulatory Support and ECMO for Cardiogenic Shock

During acute heart failure following cardiogenic shock, a mechanical circulatory support device helps the heart function. Our experts often use this device as a temporary treatment that could lead to recovery, a treatment before a long-term device is implanted, such as a ventricular assist device, or as a treatment before a heart transplant or lung transplant.

Devices used by our team include the following:

  • NuPulseCV® intravascular ventricular assist system
  • temporary biventricular assist device (BiVAD) for those who need support for the heart’s two ventricles
  • temporary left ventricular assist device for those who need support for the heart’s left ventricle
  • temporary right ventricular assist device for those who need support for the heart’s right ventricle
  • venoarterial ECMO (VA ECMO) for those who need support for the heart’s two ventricles, as well as lung support

Our team works with you to select the appropriate device for your particular condition.

ECMO Treatment for Acute Respiratory Failure

Venovenous ECMO aids recovery in a person who has severely injured lungs and is experiencing acute respiratory failure. This treatment approach is most often used to care for people experiencing severe lung infections such as pneumonia and influenza, inflammatory diseases of the lung such as acute respiratory distress syndrome, and severe airway disease conditions such as status asthmaticus.

Our team selects the most appropriate approach for each patient, which can include venovenous ECMO and other treatments. Some people with severe lung disease may benefit from venovenous ECMO before a lung transplant.

Supporting a Loved One During ECMO Treatment

When your loved one is receiving mechanical circulatory support or ECMO treatment, we understand that this can be a stressful time. Tubing, monitors, and machines are part of the treatment, and he or she might look different due to swelling related to the treatment. To ease your concerns, we encourage you to participate in daily rounds, a meeting between you and your loved one’s care team. Feel free to ask questions and share with us any information you think might be important for your loved one’s care.

After our medical team transitions your loved one from the treatment, ongoing care is often required, including additional mechanical circulatory support devices or a ventilator to assist the heart and lungs as your loved one regains strength. The length of this process is unique to each person. We encourage you to talk to our medical team for more information.