ECMO- ECLS :

The above abbreviations are used for protecting and supporting the life of a Person with the help of external devices and equipments at the time of critical threat to life due to, failure of the heart, failure of lungs , liver , or any vital organ due to various reasons. Till the time the Ventilators were introduced , there were 10 times more death in the Intensive care units , but after the common use of ventilators it helped to save millions of life across the world. Similarly once the ECMO -ECLS therapy is affordable and common in Intensive care units, we can save many more lives .

Whereas all other therapies are primarly managed by particular Specialities, ECMO can only be managed by many specialites together . Co ordination and point of care is highly significant in the management of a patient on ECMO and the proper team work is the decision maker in the Clinical Output of the therapy along with the proper selection of components and equipments .

First and second generation equiments and Devices evolved for ECMO were causing the major negative output along with lack of training and team work . Third generation devices handles the blood more similar to our body and if trained team work is assured it can make a major difference in outcome.

ECLS( Extra corporeal life support ) can be useful therapy for Patients with damaged lung due to asthma , retention of carbon dioxide , breathlessness due to different reasons , Acute poisoning , accidents , Heart attacks , Lung, liver, or heart damage due to bacteria or virus , patients who needs longer time for recovery after a major surgery of heart , lung , liver , Kidney and sometimes patients who needs very high doses of Medicines and t adverse drug reaction can be the cause of death .

During the course of therapy of ECMO without the help of different blood filters ,it is possible to filter out the poisonous elements much more faster efficiently than can be achieved by any other therapy. Dialysis for the purification of blood can be done without any extra dialysis equipment .

I prefer to use the term Modified Extra Corporial Life supprrt (MECLS) since it can be utilized for many more indications in combination with the adjunct therapies than it is being presently used.

ECLS therapy can be performed most of the times without Intubation(without ventilator) ,keeping the patient awake and conscious and can allow the organs to take rest and recover. The conscious will power of the patient if tapped also can be facilitator in healing .

ECMO is the only alternative if patients are not responding to the treatment in ventilator. Longer duration of ventilator treatment itself can cause more stiffness in lungs and eventually multi organ failure . So adapting the therapy at the right time is key factor in deciding the outcome

Financial constrains and lack of proper awareness delays the initiation of ECMO. It is most important to develop the technology and devices in India which can bring down the cost involved and larger portion of health care professionals to be proficient .

James Joseph

Certified Train the Trainers Trainer .

ECLS -ECMO , Unit Manager-BL Lifesciences .

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