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Extracorporeal Life Support Program (ECMO)

CHOC is the only institution in Orange County to offer extracorporeal life support (ECLS), also referred to as extracorporeal membrane oxygenation (ECMO), and offers the only ECLS transport for children in Orange County.

CHOC helped pioneer this lifesaving technology as one of the first institutions to use it more than 40 years ago. Today, we are one of the few centers in the world to receive a gold-level Extracorporeal Life Support Organization (ELSO) Award of Excellence in Life Support, as well as a three-year designation as an Extracorporeal Life Support Organization Center of Excellence.

State-of-the-art Technology

ECLS supports the heart and lungs by taking over the heart’s pumping function and the lung’s oxygen exchange until they can recover from injury, surgery or illness. When necessary, the machine can also be set up to support only the heart or only the lungs as needed.

ECLS at CHOC uses state-of-the-art centrifugal pumps with patients of all ages throughout CHOC, including in our operating suites, neonatal intensive care unit, pediatric intensive care unit, cardiovascular intensive care unit and emergency department. This latest form of ECLS technology requires less blood and has a lower risk of blood clotting than previous technology.

ECLS Team of Experts

Our dedicated ECLS team is composed of cardiothoracic and pediatric surgeons, intensive care and neonatal physicians, nurses, respiratory therapists and cardiopulmonary perfusionists who are experts in their fields and have received additional education to manage the complex equipment and medical needs of the children needing this life saving technology. Unlike other institutions, CHOC does not require the patient’s bedside nurse to monitor the ECLS equipment. A separate member of the ECLS team monitors the equipment around the clock thus allowing the child’s bedside nurse to concentrate solely on the patient while the ECLS expert monitors how the equipment is supporting the child. Moreover, the ECLS team is on call 24/7 and frequently is on standby for high-risk procedures in the cardiac catheterization lab and operating room should the need for ECLS occur.

Extracorporeal membrane oxygenation is now used worldwide thanks to the pioneering work of CHOC physicians more than 40 years ago.

Dr. Alan Gazzaniga

The year was 1972. A 2-1/2-year-old boy was experiencing heart failure following open-heart surgery at CHOC for transposition of the two major vessels that carry blood away from the heart—the aorta and the pulmonary artery.

Employing new technology, cardiac surgeon Alan B. Gazzaniga, MD, was able to stabilize the boy through a procedure known as ECMO, or extracorporeal membrane oxygenation. This use of membrane oxygenators for long-term support of either the lungs or heart or both was largely the result of the work of Robert H. Bartlett, MD. The CHOC patient at the time was the youngest patient to survive long-term ECMO support for postoperative heart failure.

CHOC was the first Orange County hospital to provide ECMO. Thanks to Dr. Bartlett’s continued pioneering work, today many pediatric hospitals worldwide have ECMO capabilities. It is used in both pediatric and adult patients for cardiac, pulmonary and/or circulatory failure. “It was a landmark event that pushed the use of this important modality forward,” Dr. Gazzaniga says of the 1972 procedure. The young boy remains a legacy as a key figure in the development of ECMO and in CHOC’s history.

Offering the Very Latest in Lifesaving Technology

CHOC Recognized as a Leader in Critical Care
CHOC is one of 45 centers internationally to receive a three-year designation as an Extracorporeal Life Support Organization Center of Excellence.

ECMO Can Save a Child's Life
Children who are hospitalized with critical cardiac or pulmonary disease and don’t respond to current medical treatments might be candidates for ECMO, according to Dr. Michele Domico.

Neonatology: Then and Now
Over the last 50 years, a lot has changed in the technology and medicine used to treat babies in CHOC neonatal intensive care unit.