Risks of ECMO

ECMO is a potentially life-saving, yet complex procedure and is not without risk. When a patient is sick enough to require ECMO, often the potential benefits outweighs the risks. Our team is skilled at minimizing the risks of ECMO. 

Patients who are on ECMO are very sick. ECMO is used to try to support them, but there are some risks involved.

• Bleeding is a high-risk event. When a patient is on ECMO, a blood thinner called heparin is used to keep the blood from clotting. Bleeding can occur anywhere, including in the brain. Most of the time, bleeding can be controlled. There are occasions where the bleeding is uncontrollable and the patient must be taken off ECMO. Blood transfusions are under the strict orders of the physician.
• Clots may form in the ECMO circuit or be introduced into the patient’s blood. If the clots become a concern, then the patient will require a circuit “change-out” under the order of a physician.
• Poor blood flow to the limb may occur. This can lead to a need for incisions to decompress the involved extremities, a procedure known as fasciotomy, or even amputation in the worst-case scenario.
• Any part of the ECMO circuit or machine can fail. Such things as leaks or breaks in the circuit, small amounts of air getting into the blood or failure of the oxygenator or the pump can occur. Sometimes, the cannulas need to be changed, replaced or repositioned. If necessary, a new pump and circuit can be prepared and then a change-out will occur under the physician’s order.
• Neurological (brain) problems, including strokes (bleeding into the brain or clots traveling to the brain) and seizures, can occur.
• Infection is possible. Patients are monitored very closely for signs of infection.
• The cannulas may become unsecure and detach from the patient.