ECMO Support at Toronto General Hospital

ECMO Support (Extracorporeal Membrane Oxygenation) is an advanced form of life support used for selected patients with severe respiratory or cardiac failure when conventional treatment is not providing adequate support. ECMO temporarily supports oxygenation and/or circulation while the underlying condition is treated or while further advanced care is considered.

Price

Price on Request

Why Price on Request?

The cost of ECMO support varies according to the type of ECMO, severity of illness, duration of support, intensive care requirements, procedures, medications, monitoring, hospitalization and additional treatment needs. A personalized cost estimate can be provided after specialist assessment.

Complete Description

What Is ECMO Support?

ECMO (Extracorporeal Membrane Oxygenation) is an advanced medical support technique that uses a specialized circuit outside the body to help provide oxygen to the blood and remove carbon dioxide and/or support circulation.

ECMO may be considered when the heart or lungs are unable to provide sufficient support despite intensive medical treatment.

Who May Need ECMO Support?

ECMO may be considered for selected critically ill patients with:

• Severe respiratory failure

• Severe acute lung injury

• Severe pneumonia

• Refractory hypoxemia

• Certain forms of cardiac failure

• Cardiogenic shock

• Severe respiratory or cardiac complications

• Selected patients requiring temporary support while awaiting further treatment

ECMO is not appropriate for every patient and requires specialized critical-care assessment.

Types of ECMO Support

Two major forms of ECMO support are commonly used:

• VV-ECMO (Veno-Venous ECMO) primarily supports the lungs

• VA-ECMO (Veno-Arterial ECMO) provides support for both the heart and lungs

The appropriate type depends on the patient's medical condition.

VV-ECMO for Respiratory Failure

VV-ECMO may be considered for selected patients with severe respiratory failure when the lungs cannot adequately exchange oxygen and carbon dioxide despite intensive treatment.

It may provide temporary respiratory support while the underlying lung condition is treated.

VA-ECMO for Cardiac Support

VA-ECMO can provide circulatory support for selected patients with severe cardiac failure or cardiogenic shock.

It may temporarily support:

• Heart function

• Blood circulation

• Oxygen delivery

The use of VA-ECMO depends on the patient's condition and treatment goals.

ECMO for Severe Lung Disease

Patients with severe acute lung injury or respiratory failure may sometimes require ECMO when conventional respiratory support is insufficient.

Potential underlying conditions may include:

• Severe pneumonia

• Acute respiratory distress

• Severe infection-related lung failure

• Other life-threatening respiratory conditions

Specialist critical-care assessment is required.

ECMO During Cardiogenic Shock

In selected cases of severe cardiac dysfunction, VA-ECMO may provide temporary circulatory support.

The treatment may be considered while specialists evaluate:

• Recovery of heart function

• Additional cardiac treatment

• Mechanical circulatory support

• Other advanced treatment options

ECMO as a Bridge to Recovery

For selected patients, ECMO may provide temporary support while the underlying disease is treated and the heart or lungs recover.

The duration of ECMO depends on:

• Underlying illness

• Response to treatment

• Organ function

• Overall clinical condition

ECMO as a Bridge to Lung Transplant

In selected patients with severe respiratory failure or advanced lung disease, ECMO may sometimes be used as temporary support while a patient is evaluated for or awaits lung transplantation.

Transplant eligibility and donor-organ availability remain important factors.

ECMO Assessment

Before initiating ECMO, specialists evaluate:

• Severity of respiratory or cardiac failure

• Response to conventional treatment

• Underlying disease

• Organ function

• Potential reversibility

• Bleeding and clotting risks

• Overall medical condition

• Treatment goals

The decision requires multidisciplinary critical-care expertise.

ECMO Cannulation

ECMO requires specialized placement of large blood vessels called cannulas to connect the patient to the ECMO circuit.

The cannulation approach depends on:

• Type of ECMO

• Patient anatomy

• Clinical condition

• Required level of cardiac or respiratory support

ECMO Monitoring

Patients receiving ECMO require continuous intensive-care monitoring.

Care may include assessment of:

• Oxygenation

• Carbon dioxide levels

• Blood pressure

• Heart function

• Lung function

• Blood clotting

• Blood counts

• Kidney function

• Liver function

• ECMO circuit performance

ECMO Medication Management

Patients receiving ECMO may require medications to manage their underlying condition and the ECMO circuit.

Treatment may include:

• Anticoagulation when appropriate

• Antibiotics when infection is present

• Sedation

• Pain management

• Blood-pressure medications

• Other critical-care medications

Medication management is individualized according to the patient's condition.

ECMO and Respiratory Support

ECMO may be used alongside other respiratory-support strategies.

Depending on the patient's needs, care may include:

• Mechanical ventilation

• Oxygen therapy

• Respiratory monitoring

• Lung-protective ventilation

• Pulmonary care

• Respiratory rehabilitation when appropriate

ECMO Complication Monitoring

ECMO is a highly specialized therapy and requires close monitoring for potential complications.

Medical teams may monitor for:

• Bleeding

• Blood clots

• Infection

• Changes in blood counts

• Kidney problems

• Neurological complications

• Circuit-related complications

• Other critical-care complications

ECMO Weaning

When the heart or lungs demonstrate sufficient improvement, specialists may assess whether ECMO support can be reduced.

Weaning assessment may consider:

• Improved oxygenation

• Improved lung function

• Improved heart function

• Stable blood circulation

• Reduced dependence on ECMO

The process is carefully monitored by the critical-care team.

Multidisciplinary ECMO Care

ECMO treatment requires collaboration between multiple healthcare professionals, which may include:

• Critical-care physicians

• Cardiothoracic surgeons

• Respirologists

• Cardiologists

• Perfusion specialists

• Specialized nurses

• Respiratory therapists

• Pharmacists

• Rehabilitation professionals

• Other healthcare specialists

ECMO Second Opinion

Patients or families may seek an ECMO treatment second opinion regarding:

• Whether ECMO is appropriate

• Type of ECMO required

• Severe respiratory failure

• Cardiogenic shock

• Lung transplantation

• Advanced critical-care treatment

• Previous ECMO recommendations

Medical records and clinical information can be reviewed during specialist assessment.

International Patient ECMO Support

International patients requiring advanced critical care in Canada should provide relevant medical documentation whenever possible.

Records may include:

• Intensive-care reports

• Imaging

• Blood-gas results

• Cardiac investigations

• Respiratory investigations

• Previous treatment records

• Medication list

• Current clinical status

ECMO is an emergency and highly specialized therapy, and access depends on clinical urgency, medical eligibility, hospital capacity and applicable requirements.

Benefits of Specialized ECMO Support

For appropriately selected critically ill patients, ECMO may:

• Provide advanced respiratory support

• Support circulation

• Improve oxygen delivery

• Remove carbon dioxide

• Provide temporary support while treating the underlying condition

• Support selected patients awaiting advanced treatment

• Provide a bridge to recovery or transplantation in appropriate cases

Why Choose Toronto General Hospital for ECMO Support?

Toronto General Hospital (TGH) is part of University Health Network (UHN) and provides highly specialized complex medical, surgical and critical-care services.

Patients requiring advanced cardiopulmonary support may be assessed through the relevant specialized UHN programs according to their clinical condition and medical requirements.

ECMO candidacy and availability depend on specialist assessment and the patient's clinical circumstances.

Cost & Price on Request

Price: Price on Request

The total cost of ECMO support depends on the patient's condition, type and duration of ECMO and level of intensive care required.

Potential costs may include:

• Critical-care consultation

• ECMO assessment

• Cannulation

• ECMO support

• Intensive care

• Continuous monitoring

• Laboratory testing

• Imaging

• Medications

• Blood products when required

• Respiratory support

• Surgical procedures when necessary

• Rehabilitation

• Follow-up care

A personalized cost estimate can be requested following specialist assessment.

Frequently Asked Questions

1. What does ECMO do?

ECMO provides temporary support for the lungs, heart or both by helping oxygenate blood and remove carbon dioxide and, in some cases, support circulation.

2. What is the difference between VV-ECMO and VA-ECMO?

VV-ECMO primarily provides respiratory support, while VA-ECMO provides both circulatory and respiratory support.

3. Can ECMO be used as a bridge to lung transplantation?

In selected patients with severe respiratory failure or advanced lung disease, ECMO may provide temporary support while transplant options are evaluated.

4. How long does a patient remain on ECMO?

The duration varies significantly depending on the underlying condition, response to treatment and recovery of heart or lung function.

5. Can international patients receive ECMO support in Canada?

ECMO is highly specialized critical care. Access depends on clinical urgency, specialist assessment, hospital capacity, medical eligibility and applicable requirements.

Product Details

Product Name: ECMO Support

Hospital: Toronto General Hospital

Brand: Toronto General Hospital

Country: Canada

Specialty: Thoracic Surgery & Lung Care

Service Type: ECMO Support

Customer-Facing Price: Price on Request

International Patients: Subject to applicable eligibility and program requirements

Location: Toronto, Ontario, Canada