ECMO — A Lifesaving Lung Transplant Procedure

ECMO is short for extracorporeal membrane oxygenation. An ECMO machine is similar to heart-lung bypass machines utilized in open-heart surgery. It is used to pump and oxygenate the blood of a patient outside the body to let the lungs and heart rest. When a patient is connected to the ECMO machine, the blood flows through tubes to artificial lungs in the machine that take out carbon dioxide and add oxygen. After this, the blood gets warmed to body temperature before being pumped back into the body.

Types of ECMO treatment in India

Two kinds of ECMO exist at present. They are:

VA ECMO:

VA ECMO remains connected to both an artery and a vein. It is used when there are issues with both the lungs and heart.

VV ECMO:

VV ECMO remains connected to one or multiple veins located near the heart. It is useful when the issue is solely in the lungs.

When to use ECMO machines

ECMO is useful when it comes to:

• Patients who are recovering from heart surgery, lung failure, or heart failure
• Offering support during the high-risk processes in the cardiac catheterization lab
• A bridge for heart assistance devices like a left ventricular assist device
• A bridge for the patients waiting for a lung transplant. It helps to keep the tissues oxygenated, which makes patients better candidates for the transplant.
• Acting as a bridge for further treatment, the doctors aim to assess the condition of other organs like the brain or kidneys before carrying out lung or heart surgery.

ECMO treatment cost in India

The ECMO treatment cost in India, excluding the charges for the hospital, for the initial two days is nearly ₹1.75 lakh to ₹3 lakh each day. Thereafter, about ₹80,000 to ₹1 lakh is charged per day. Of course, the charges vary from one hospital to another. Several patients may need the treatment for at least a month or more. For the hospital, the machine will cost nearly ₹35 lakh. The ECMO kit that comprises medical consumables costs around ₹3 lakh. Doctors suggest this procedure as a last resort for the patients.

The machines are not easy to purchase because they need to be imported and are in short supply. Apart from higher costs, providing the treatment is labor-centric. There has to be at least one intensivist and two nurses present to consistently monitor the patient. There also has to be a skilled surgeon present.

Risks associated with the ECMO treatment

ECMO comes with a host of risks as well, such as:

• Infection at the points where the tubes reach the body
• A greater chance of stroke
• Small air bubbles or clots form in the tube
• Bleeding because of the medication administered to prevent from forming clots in the tube
• Transfusion issues because a person on the ECMO machine is administered blood products

It is important to talk to a doctor to know about the treatment in detail before proceeding.