ECMO (Extracorporeal Membrane Oxygenation)

When someone’s heart or lungs suddenly fail, every minute matters. In these critical moments, doctors sometimes turn to one of the most advanced forms of life support available today: ECMO, or Extracorporeal Membrane Oxygenation.

ECMO is not a treatment that fixes a disease, but it can keep both infants and adults alive when their heart or lungs are too weak to do their job. It gives the body time to rest, recover or respond to other life-saving therapies.

What Is ECMO?

ECMO (Extracorporeal Membrane Oxygenation) is a type of advanced life support that temporarily takes over the work of the heart, lungs or both.

The ECMO machine does three main things:

• Removes blood from the body
• Adds oxygen and removes carbon dioxide
• Pumps the blood back into the patient

ECMO can be thought of as a temporary external heart and lung system that keeps oxygen flowing to vital organs when the body can’t do it on its own. This allows the heart and lungs to rest while doctors treat underlying problems.

ECMO can be used for patients of all ages, from critically ill newborns and children to adults.

Is ECMO Considered Life Support?

Yes, ECMO is one of the most advanced forms of life support used in modern medicine. It’s typically used in intensive care units (ICUs) for patients who would not survive without it.

ECMO is used only when:

• The lungs cannot deliver enough oxygen, even with a ventilator and high levels of oxygen, such as in severe pneumonia, ARDS or COVID-19–related lung failure

• The heart cannot pump enough blood to supply vital organs, such as after a massive heart attack, cardiac surgery complications or sudden heart failure

• Both the heart and lungs are failing, which can happen with overwhelming infection (sepsis), major trauma or cardiac arrest

How Does an ECMO Machine Work?

An ECMO system includes:

• Large tubes (cannulas) that are placed into blood vessels
• A pump to move blood through the system
• An oxygenator (sometimes called an artificial lung)

When a patient is placed on an ECMO machine, blood is gently circulated out of the body through a tube, where the machine removes carbon dioxide and adds fresh oxygen. The oxygen-rich blood is then returned to the patient.

This process runs continuously, 24 hours a day, allowing the body to receive the oxygen it needs while the heart and lungs get time to recover.

What Happens While Someone Is on ECMO?

While on ECMO, patients are cared for in the ICU by a specialized team that can include:

• Critical care doctors
• Cardiologists and pulmonologists
• Surgeons
• Nurses trained in ECMO care
• Respiratory therapists
• Perfusionists (ECMO specialists)

During this time, doctors continue treating the cause of the failure, such as infection, heart damage, blood clots or lung injury. The goal is always to support the body until it can take over again, and ECMO is no longer needed.

What Is ECMO Used For?

ECMO provides heart and lung support in the most serious medical emergencies. It’s often used when standard treatments, such as oxygen, ventilators or medications, are no longer sufficient.

Conditions ECMO can be used to support include:

• Severe pneumonia or respiratory failure (when oxygen levels stay dangerously low despite a ventilator)
• COVID-19 or other viral lung injuries
• Acute respiratory distress syndrome (ARDS)
• Severe heart failure or cardiogenic shock
• Cardiac arrest or failure to regain circulation after CPR (ECPR)
• Complications following heart surgery or transplant
• Major trauma, near-drowning or inhalation injury
• Life-threatening heart or lung conditions in newborns and infants, such as persistent pulmonary hypertension of the newborn (PPHN), congenital diaphragmatic hernia or complications after congenital heart surgery

How Long Can Someone Stay on ECMO?

How long someone stays on ECMO depends on the patient and the condition being treated.

Most patients remain on ECMO for about 4-7 days to a few weeks, depending on how quickly the heart or lungs begin to recover.

During this time, doctors and critical care specialists closely monitor progress each day, gradually reducing support as the patient’s own organs become strong enough to take over.

Some may need ECMO longer, such as if recovery is slow or if it’s being used as a bridge to:

• Heart or lung transplant
• Surgery
• Long-term recovery

When Is ECMO Stopped?

This process of ending ECMO is done carefully, step by step, to ensure the patient’s body is ready.

ECMO is reduced and removed when:

• The lungs can deliver enough oxygen
• The heart can pump blood on its own
• The patient remains stable without machine support

ECMO at Stony Brook Medicine

The Stony Brook Heart Institute is recognized as a leader in ECMO therapy, performing more ECMO procedures than any other institution in the area. Our ECMO program allows our heart, lung, and critical care specialists to provide this advanced level of life-saving support to patients across Long Island and beyond.

Having ECMO capability means that Stony Brook Medicine can treat some of the sickest patients, offering hope in situations that once had very few options. If you or a loved one is facing severe heart or lung failure, our ECMO team is equipped to deliver the highest level of critical care, right when it matters most. Learn more about our services here or make an appointment by calling (631) 44-HEART (444-3278).

What began as flu-like symptoms quickly escalated into a life-threatening emergency for Kristin Fludder. After collapsing at home, she was rushed to Stony Brook University Hospital, where she was diagnosed with viral myocarditis and multi-system organ failure. Kristin, a mother of two, was placed on ECMO for advanced cardiac and respiratory support, intubated, and received dialysis for kidney failure. Thanks to the expert care and unwavering support of the Stony Brook Heart Institute team, Kristin defied the odds. Her strength – and that of her family – carried her through a harrowing medical journey that ultimately led to the birth of a precious little miracle. This is a powerful story of resilience, hope, and the life-saving impact of quality, compassionate care.