personal ECMO question

[littlepeach]

although i do work NICU, i don't deal with ECMO. my bff's baby is on the heart transplant list d/t hypoplastic left heart and recently took a nose dive in his stability. put him on ECMO until he gets his new heart..but not sure if he can hold out. what kind of a window are we looking at that he will possibly be able to be weaned off? i know this is a last ditch effort. he's going on 24 hours now worth of ECMO support and still waiting for his heart. i know pre-surgical ECMO is usally the beginning of the end. Any expert opionion of my fellow nurses would be greatly appreciated.

[dawngloves, BSN, RN]

I am sorry your friend's baby is so sick. I hope he gets his heart soon. I have no ECMO experience, but it does sound bad. I hope I am wrong.

[SteveNNP, MSN, NP]

ECMO is a last-ditch effort. Once the baby is heparinized, and has his blood circulating through a pump, the clock is ticking. Many babies eventually have bleeding, platelet dysfunction, vascular instability, etc, simply from being on ECMO, not even considering preexisting conditions. I hope the baby finds a heart soon. The longest I've seen a baby on ECMO is 12 days.

[ittybabyRN, RN]

I am very new, however our hospital had a baby on ECMO during my orientation who was waiting for a new heart, he was on it over a month before they transferred him, on ecmo, to chop (we don't do heart transplants at my hospital). He was on ecmo for an endocarditis, we also have a CICU so the babies with congenital heart diseases go there and I don't know what they do for ecmo and how long their babies stay on it over there.

Usually though our ECMO runs last 4-7 days and mostly kids with PPHN, MAS and CDH though this past winter we had quite a few RSV babies get so sick they needed ECMO too.