eli5: Why do Heart-Lungs bypass machine can’t keep someone alive for more than days?
In: 155
Exposure to all of the foreign surfaces from the heart lung machine also chews up the clotting factors the longer you are on bypass.
Exposure to all of the foreign surfaces from the heart lung machine also chews up the clotting factors the longer you are on bypass.
As others mentioned, patients can be on ECMO for months, but it’s an incredibly invasive procedure. Blood clots can form and clog up the machine causing catastrophic failure, they can form in the brain and other organs which is why they’re on heparin which can cause the opposite problem. If the cannulas become dislodged you can bisect arteries and veins. Had one patient they were trying to place on ECMO, the aorta was bisected in the process and they bled out in minutes
Anytime you introduce something foreign to the body you are risking infection. Secondary infections/pneumonias are common and cause more damage to the already weak and damaged body
Have had patients, particularly COVID patients where the machine simply couldn’t compensate enough for the failing lunge/heart and organ transplants take a long time to get. Organs enduring low oxygenation/blood pressures for weeks leading to organ failure and brain injuries
To save the body you put it through extremes that can fuck it up in new ways. Frankly saving a life at any cost is not always worth it
As others mentioned, patients can be on ECMO for months, but it’s an incredibly invasive procedure. Blood clots can form and clog up the machine causing catastrophic failure, they can form in the brain and other organs which is why they’re on heparin which can cause the opposite problem. If the cannulas become dislodged you can bisect arteries and veins. Had one patient they were trying to place on ECMO, the aorta was bisected in the process and they bled out in minutes
Anytime you introduce something foreign to the body you are risking infection. Secondary infections/pneumonias are common and cause more damage to the already weak and damaged body
Have had patients, particularly COVID patients where the machine simply couldn’t compensate enough for the failing lunge/heart and organ transplants take a long time to get. Organs enduring low oxygenation/blood pressures for weeks leading to organ failure and brain injuries
To save the body you put it through extremes that can fuck it up in new ways. Frankly saving a life at any cost is not always worth it
As others mentioned, patients can be on ECMO for months, but it’s an incredibly invasive procedure. Blood clots can form and clog up the machine causing catastrophic failure, they can form in the brain and other organs which is why they’re on heparin which can cause the opposite problem. If the cannulas become dislodged you can bisect arteries and veins. Had one patient they were trying to place on ECMO, the aorta was bisected in the process and they bled out in minutes
Anytime you introduce something foreign to the body you are risking infection. Secondary infections/pneumonias are common and cause more damage to the already weak and damaged body
Have had patients, particularly COVID patients where the machine simply couldn’t compensate enough for the failing lunge/heart and organ transplants take a long time to get. Organs enduring low oxygenation/blood pressures for weeks leading to organ failure and brain injuries
To save the body you put it through extremes that can fuck it up in new ways. Frankly saving a life at any cost is not always worth it
A couple things to keep in mind:
1. Anyone on one of these machines is extremely sick and inevitably has a lot more problems than just this process
2. Complications from the meds/process of the ecmo itself as others have pointed out
3. There is not much utility in just keeping someone’s body ‘alive’ unless there is an end point—some intervention that you can do to actually fix the underlying issue that caused them to need to go on the machine in the first place.
A couple things to keep in mind:
1. Anyone on one of these machines is extremely sick and inevitably has a lot more problems than just this process
2. Complications from the meds/process of the ecmo itself as others have pointed out
3. There is not much utility in just keeping someone’s body ‘alive’ unless there is an end point—some intervention that you can do to actually fix the underlying issue that caused them to need to go on the machine in the first place.
A couple things to keep in mind:
1. Anyone on one of these machines is extremely sick and inevitably has a lot more problems than just this process
2. Complications from the meds/process of the ecmo itself as others have pointed out
3. There is not much utility in just keeping someone’s body ‘alive’ unless there is an end point—some intervention that you can do to actually fix the underlying issue that caused them to need to go on the machine in the first place.
Latest Answers