ECMO is a type of life support for people with severe heart and lung conditions. ECMO involves a machine that pumps your blood (when your heart can’t) and adds oxygen to it (when your lungs can’t).

An extracorporeal membrane oxygenation (ECMO) machine, also called extracorporeal life support, takes over the function of your heart and lungs. This machine:

  • pumps your blood for you
  • removes carbon dioxide from your blood
  • adds oxygen to your blood

ECMO is a last resort type of life support that’s used to help people survive life threatening heart or lung conditions.

According to the Extracorporeal Life Support Organization (ELSO) registry, over 203,000 people have received ECMO as of July 2023, including over 48,000 babies and 36,800 children.

Read on to learn when ECMO is used, the risks, and what the ECMO procedure looks like.

ECMO is used to save the lives of people with severely compromised heart or lung function. It may also be used to support people waiting for or recovering from a heart transplant or lung transplant.

ECMO allows blood to bypass your heart and lungs and go to a machine outside of your body. It’s an advanced life support system that may be an option if other breathing machines — like ventilators — aren’t effective.

Doctors have been successfully using ECMO in babies with severe lung or heart failure for about 40 years, but it’s only been successfully used in adults for about the last decade.

ECMO can potentially treat many different conditions that severely compromise your lung or heart function. Some of these conditions include:

Most of the time, ECMO is implemented in an emergency situation in an intensive care unit (ICU). You may not be conscious when doctors connect you to the device. If you’re awake, you may be given sedative medications to help you feel relaxed.

A type of doctor called a perfusionist can connect you to an ECMO machine, adjust the settings, and monitor you.

Doctors attach an ECMO machine with two plastic tubes called cannulas, which are placed into large blood vessels in your leg, chest, neck, or other body part.

Blood will be pumped through one of these tubes and drained into a plastic pouch outside of your body.

The blood is then pumped through a membrane oxygenator, which acts as an artificial lung that exchanges oxygen and carbon dioxide from your blood.

After the blood passes through this artificial lung, it passes through a heater to warm the blood to your body temperature. The blood will then reenter your body through the second tube.

Types of ECMO

There are 2 main types of ECMO:

  • Venoarterial ECMO: This type of ECMO allows most of your blood to bypass your lungs and heart completely. The blood flows out of a major vein and flows back from the ECMO machine into a major artery.
  • Venovenous ECMO: A venovenous ECMO supports your lungs only. It may be used if your heart is still healthy enough to pump your own blood. Your blood is taken from and returns to a major vein.

ECMO is meant as a short-term treatment for serious heart or lung conditions. It can be a bridge to a life saving organ transplant or help you recover from a transplant.

Some people on ECMO may never recover, which can raise difficult end-of-life decisions for family members.

Learn more about making life support decisions.

How long can a person be on an ECMO machine?

An ECMO machine is usually used until the underlying condition is treated. People may be on ECMO for days to weeks. Complications tend to develop more frequently the longer you’re on ECMO.

Weaning off of ECMO is one of the most challenging parts of treatment. Doctors can initiate the weaning process by reducing the amount of blood that pumps through your ECMO circuit. They’ll make the decision to take you off ECMO when your vitals and blood tests suggest you can survive without it.

Your doctor may decrease blood flow in steps at least an hour apart to help your body prepare to adjust to the new blood flow.

If you recover enough to come off of ECMO completely, your doctor will remove your cannulas and treat your wounds with stitches and bandages to prevent bleeding. You may be transferred to a ventilator until you can breathe well enough on your own.

Bleeding is the most common complication of ECMO. Other complications include:

Some questions people ask about ECMO include:

What does ECMO stand for?

ECMO stands for extracorporeal membrane oxygenation. “Extracorporeal” means outside of your body.

What is an ECMO machine?

An ECMO machine is a device that takes over the function of your lungs and heart. It pumps your blood outside of your body and sends it through devices that add oxygen and remove carbon dioxide.

Is ECMO life support?

ECMO is a last resort type of life support. It’s also known as extracorporeal life support.

Can a person die while on ECMO?

ECMO is only used in people with severe heart or lung failure. Some people can die while on an ECMO machine.

The Extracorporeal Life Support Organization registry lists the survival rate to discharge or transfer in people who have received ECMO as 54% overall and 65% in babies.

ECMO is a type of life support used to save people with severe lung or heart failure. It involves pumping your blood with an external machine. This machine also takes over the function of your lungs by exchanging oxygen and carbon dioxide.

ECMO can also be used to help people survive until an organ transplant becomes available or help them survive after the transplant. Some people don’t recover enough to come off of ECMO. This means that loved ones will need to make an end-of-life decision.