Do you know “ECMO”, the technology of artificial lungs and hearts Increasing the survival chances of emergency patients How to use it? Ready to introduce ECMO machine price in Thailand
Currently, about 70,000 Thais suffer from heart disease every year, and there are still many critically ill patients who cannot access adequate treatment. As a result, the number of deaths from heart and lung disease is increasing every year. “ECMO” ECMO (Extracorporeal Membrane Oxygenation) is also known as “ECLS” ECLS (Extracorporeal Life Support), which is a portable heart and lung support device. Cardiopulmonary bypass is intended to replace heart and lung function. When organs are unable to function to their full potential It is usually only seen in patients with cardiopulmonary emergencies. The details of the behavior are as follows.
Working principle of the ECMO machine
As mentioned above, the main objective of the ECMO (Extracorporeal Membrane Oxygenation) machine is to replace the work of the heart and lungs which cannot work at full efficiency. It has the same function as a water pump. it is the addition of gaseous oxygen into the arteries or veins AND taking out the carbon dioxide similar to the work of human lungs through plastic tubes (cannulae), resulting in the heart organs returning to respond to work together fully.
The Thai team I would like to explain the working model of the ECMO machine step by step so that the reader can see the working picture more clearly.
1. Draw blood from the patient. This involves inserting a thumb-sized plastic tube through a blood vessel in your arm, neck, or leg. In some cases, it can also be inserted directly into the heart through an opening in the chest. But most often it is worn from the groin area to the heart. that the insertion must not damage blood vessels and not penetrate the heart
2. At least two plastic tubes are inserted into the body, one of which is used to remove blood from the body. The other tube brings blood back into the body. Therefore, when you take blood from your body into the machine The machine will fill with oxygen and adjust the temperature accordingly. To regulate the temperature such as in the case of a patient with fever or in cardiac arrest for a long time. To keep the body temperature low in order to maintain the cells in the brain, temperature control from the machine is used.
3. For adding oxygen, in some cases, patients with lung diseases that cause lungs to stop, such as COVID-19 infection from COVID-19 patients Some of them have germs that destroy lungs. This causes the lungs to stop working for a while, which can last for several weeks. Using an ECMO machine can help buy time. By adding oxygen to the blood to replace the work of the lungs. The principle is to draw blood and add oxygen to the outside through a pump. then returned to the body again
4. After completing the oxygenation it must pass through a conical pump which continues to circulate the blood and returns it to the patient’s body. This pump can be used to replace the work of the heart. Therefore, in the event that the heart is not beating, such as a heart attack or coronary heart disease patients causing myocardial infarction, it will not work. can use this tool to replace the work of the heart itself
Types of ECMO machines
For the type of ECMO machine, there are 3 types for you to choose, consisting of VA – ECMO, VV – ECMO, AV – ECMO, each usage type differs depending on the patient and doctor’s opinion. There are details as follows.
1. Veno-arterial ECMO (VA-ECMO)
Veno – arterial ECMO (VA – ECMO) is an ECMO. This helps in gas exchange and supports blood circulation. As blood is pumped from the veins into the arteries This system will help with the work of the heart and lungs. as well as the systems used in cardiac surgery laboratories.
2. Veno – venous (VV – ECMO)
Subsequent veno-venous (VV-ECMO) assists gas exchange only. The blood will be drawn from the vein and pumped back into it. This system will only work with the lungs.
3. Arteriovenous ECMO (AV – ECMO
The last type of ECMO is arteriovenous ECMO (AV-ECMO). It assists in gas exchange by using blood pressure to pump blood from the venous to the arteries.
What kind of patients shouldn’t use ECMO?
Although ECMO is an emergency portable heart-lung implant, however, not all patients will be able to use ECMO. patients damaged an organ that cannot be restored or multiple organ failures. And most doctors will not recommend it to patients who cannot take blood thinners. Using an ECMO machine for treatment
Complications during the use of ECMO
For complications of patients using ECMO, there are 6 initial symptoms. According to information from medical professionals as follows
- Most patients require continuous anticoagulant therapy, and more than 50% of patients experience bleeding.
- Thromboembolism is an obstruction in the ECMO circuit that can affect the function of the oxygen pump or oxygenator. In VA – ECMO can lead to a stroke or ischemia of the leg.
- Management of ECMO will include blood monitoring to determine optimal clotting balance.
- Infectious complications may be related to permanence lines, access sites, or primary disease.
- If the ECMO cycle fails or stops, it can lead to serious heart conditions. But it’s unusual as long as all components are safe.
- Cannulas (plastic tubes) can be a problem if they are loose or in the wrong place. It affects blood flow and ECMO performance.
However, for the safety of patients during use. A trained staff member should be with the patient at all times. Check the integrity of the ECMO cycle regularly to prevent problems and respond promptly to acute failure
The cost of using an ECMO machine in Thailand
For patients who want to choose an ECMO machine to support the functioning of heart and lung organs. He should consult many medical professionals along with family members before making a decision why ECMO is an advanced medical technology. they have a high cost AND it must be a multidisciplinary collaboration that requires specialized personnel. Also, the cost of the expenses depends on the severity of the patient’s symptoms. Types of ECMO machines, duration of use Including selected hospitals in use therefore making the price uncertain depending on the case
In summary, the “ECMO” machine does not have the primary function of maintenance But the purpose is to support or support the functioning of the pulmonary and cardiac organs that cannot function effectively. return to respond to work as before it must be used under the supervision of a particular physician. And if you choose to use it, you should consult carefully for cost planning and guidelines for further use.
refer : Bangkok hospital, Mayo Clinic, Johns Hopkins medicine
