If your child is critically ill, the need for heart and lung support may be necessary to help your child heal or until your child gets a transplant. Mechanical circulatory support, also known as extracorporeal membrane oxygenation (ECMO), is a type of heart-lung bypass used to pump oxygenated blood to the body when your child’s heart or lungs aren’t functioning properly or need to rest. You may also hear it called ECLS, which means extracorporeal life support.
St. Louis Children’s Hospital is a Gold Center of Excellence and serves as one of the region’s leading ECMO centers. Our team has performed more than 1,250 ECMO runs since 1985, placing us among one of the world’s most experienced pediatric ECMO centers.
Providing Life-Saving Intervention for Critically Ill Infants and Children
When infants and children are placed on ECMO, a mechanical pump (artificial heart), a membrane (artificial lung), and a blood warmer circulate blood and oxygen throughout the body without making a child’s heart or lungs work to do it.
There are two types of ECMO, and depending on your child’s illness, both can be used for short or long periods of time:
- Veno-venous (VV) ECMO does the work of your child’s lungs while your child’s heart continues to pump blood to the body.
- Veno-arterial (VA) ECMO does the work of your child’s heart and lungs.
While your child is on ECMO and being cared for at St. Louis Children’s Hospital, you have direct access to pediatric specialists across every specialty that your child may need – without having to leave the building. Our experienced medical team manages and monitors ECMO patients and communicates with families.
Lifesaving Care and Transport for Patients
For pediatric patients on ECMO at outside hospitals, we are one of only a few centers in the country with ECMO transport capacity. Our transport team includes a critical care physician, perfusionist and a critical care transport nurse, along with an ECMO circuit to support your child’s cardio-pulmonary needs. We have specially equipped aircraft for transporting patients who are outside of our immediate area.
What to Expect When Your Child Is on ECMO
Hearing that your child needs ECMO can be overwhelming. If your child needs ECMO, a team of surgeons will place tubes (called cannulas) into large blood vessels in the neck, chest or groin. These tubes are connected to the ECMO machine that removes blood from your child’s body, adds oxygen, removes carbon dioxide, and warms the blood before returning the blood to your child.
Before your child is placed on ECMO, they will receive general anesthesia and may be sedated afterward if they are restless. You will be able to touch and talk to your child while they are on ECMO support. We encourage you to be in the room with your child as much as you can. Your child can be comforted by hearing your voice and knowing you are there, which can be immensely helpful.
Family-Centered Approach for ECMO Treatment
We understand that having a child in the hospital can take a toll on families. That’s why our care team focuses on you and your child, not the clock. Your family is at the center of everything we do during this critical time.
As part of our comprehensive care, you will see doctors with different specialties working alongside support professionals to address all aspects of your child’s health. During daily rounds (bedside visits), we talk to parents and families about treatment progress and listen and answer questions.
When Does a Child Need ECMO?
If your child has a severe lung and/or heart condition that hasn’t responded to standard medical therapies, they may be recommended for ECMO. At St. Louis Children’s Hospital, we use ECMO to help provide heart and lung support for children with a variety of medical problems and conditions, including:
- Aspiration pneumonia
- Bridge to diagnosis and definitive care
- Bridge to heart, lung, heart-lung and heart-liver transplantation
- Bridge to ventricular assist devices (VAD)
- Cardiac arrest
- Congenital heart conditions
- Congenital high airway obstruction (CHAOS)
- Congenital diaphragmatic hernia (CDH)
- Cystic lung disease
- End-stage cardiac or respiratory failure
- Neonatal meconium aspiration syndrome
- Postoperative support after cardiac surgery
- Pulmonary hypertension
- Respiratory distress
- Severe infection or sepsis
- Severe pneumonia
- And others
Our Advanced Technologies
As a Gold Center of Excellence award recipient from ELSO (the Extracorporeal Life Support Organization), we are committed to patient safety and providing advanced care for our most critically ill patients.
As part of our commitment to providing exceptional care for our patients, we are the only hospital in the region to have advanced ECMO specialists with specialized training. These nursing experts have in-depth knowledge about the ECMO pump’s inner workings, are trained to handle emergencies and are an integral part of your child’s healthcare team.
We also have one of the largest neonatal ECMO programs in the Midwest, with experienced neonatologists and nurses trained in ECMO.
Meet the Experts
Throughout ECMO treatment, your child is at the center of highly coordinated care and receives round-the-clock monitoring. Our ECMO team is made up of a multi-disciplinary team of more than 50 specialists who provide personalized care for every patient we treat.
Meet the team at the Heart Center.
Life After ECMO
When your child is first placed on ECMO, the pump flow is kept high to allow the lungs and heart to rest. As the heart and lung function improves, we decrease the ECMO flow, so the heart and lungs do more work. As your child’s condition improves, ECMO can be discontinued.
Depending on your child’s illness, we provide follow-up care and support to improve your child’s development and quality of life. We will continue to follow your child’s progress and are available as a resource before – and after – going home.
Our Pediatric Neurocritical Care, Cardiac Neurodevelopment Programs (CNDP) and Neonatal ECMO Long-Term Developmental Follow-up Program provide multi-disciplinary care in an outpatient setting. Close follow-up is essential throughout childhood because as children grow and develop, new challenges may become evident. With early detection, these issues can be addressed with therapy and other treatments when they can make the biggest impact.
Some of the other resources we offer following ECMO treatment are:
- Physical therapy
- Neurocritical Care Program (NCFP)
- CDH diagnosis and follow-up care
- Pediatric Advanced Care Team (PACT)
- Occupational, physical, and speech therapies
- Teacher liaison to assist with back-to-school transition
Connect With St. Louis Children's Hospital
While your child is on ECMO, their healthcare team is available 24 hours a day. If you have any questions about any aspect of their care, please do not hesitate to reach out. If you need more information or a second opinion, contact 314-454-KIDS or email us. For patient referrals, call Children's Direct at 800.678.HELP (4357).