Whom Do We Treat?

Adult Patients

Our adult program offers veno-venous1 and veno-arterial2 extracorporeal life support.

Veno-venous ECMO may be used in patients with refractory hypoxemic or hypercarbic respiratory failure from various etiologies, including:

• acute respiratory distress syndrome
• severe influenza (such as H1N1)
• status asthmaticus
• massive air leak syndromes

ECMO can provide critical time for lung recovery while avoiding the ventilator-associated lung injuries that can occur with traditional mechanical ventilation.

Veno-arterial life support is used for patients whose hearts are not adequately supporting circulation or who have suffered cardiac arrest. Veno-arterial ECMO may be considered for a variety of critical illnesses, including:

• septic shock
• pancreatitis
• heart failure
• overdose
• peri-partum complications

This is an exciting addition to our world-class pulmonary critical care program, putting us at the absolute forefront of cardiac and pulmonary support center in the region.

Neonatal and Pediatric Patients

Our pediatric ECMO program is extremely versatile, providing care for pediatric patients of all ages, from neonates to adolescents. Depending on the patient’s needs, we offer both veno-venous1 and veno-arterial2 extracorporeal life support. ECMO can be used to support infants and children with respiratory failure due to many different diagnoses, including:

• Meconium Aspiration Syndrome
• Respiratory Distress Syndrome
• Persistent Pulmonary Hypertension / Persistent Fetal Circulation
• Air Leak Syndrome
• Congenital Diaphragmatic Hernia
• Viral / Bacterial Pneumonia
• Influenza
• Aspiration Pneumonitis
• Acute Respiratory Distress Syndrome
• Sepsis

Hasbro Children's Hospital is one of the busiest pediatric centers in New England, and was the first hospital in Rhode Island to pioneer the use of ECMO, in collaboration with the department of neonatal-perinatal medicine at Women & Infants Hospital.

References

1. Veno-venous life support, or respiratory assistance for lung disorders, is primarily used when the heart is still able to pump blood through the circulatory system without any additional support, as in the case of acute respiratory failure or a massive pulmonary embolism. The blood is removed from the jugular vein or a femoral vein for enrichment with oxygen, after which it is returned to a vein.

2. Veno-arterial life support is used with patients whose hearts are not adequately supporting their circulation or whose hearts have stopped, which may occur with a myocardial infarction. In this case, it is vital to ensure cardiopulmonary support as early as possible to prevent organ damage. Blood is removed from the right atrium or a femoral vein and returned to the aorta or a femoral artery after oxygenation. Some of the blood bypasses the heart in a parallel circulatory system, thus relieving stress on the heart muscle.