Initially, when the patient is placed on ECMO, the pump flow is kept high to allow the heart and lungs are allowed to rest. As the heart and lung function begins to improve, the ECMO flow will be decreased, allowing the heart and lungs to do more of the work.
The function of the heart and lungs are measured by blood samples, chest x-rays, chest movement and echocardiogram. Once the patient's condition has improved, the ECMO flow is decreased and the patient is tried off pump for a couple of hours.
If during this time, the patient remains stable, ECMO can be discontinued and the patient will require full ventilation which will also be reduced once the patient improves. Once ECMO is discontinued, the catheters will be removed from the neck and the vessels will be repaired.
A recent quality-of-care assessment of the Pediatric Intensive Care Unit (PICU) at Nicklaus Children's conducted by the National Association of Children's Hospitals compares patient outcomes with results obtained from similar intensive care units around the country. Nicklaus Children's PICU was ranked excellent, the number one unit in the study, due principally to better than predicted results obtained in caring for the highest risk patients.