In a dimly lit intensive care unit, the whispering of a machine is heard – the extracorporeal membrane oxygenation (ECMO) device, which acts as a makeshift heart and lungs, buying precious time for life. This technology, although costly, costs tens of thousands of yuan a day, can be the last hope to save lives in some critical moments. However, there is a controversy surrounding this technology: can ECMO really save patients who are on the verge of death in the face of such high costs?
When a patient with severe respiratory failure is ineffective and his vital signs are becoming weaker, the doctor recommends ECMO as a last resort。Families are faced with a difficult choice: should they bear the high costs, or should they give up the chances of survival? This is not only an economic issue, but also a moral and emotional choice.
Extracorporeal membrane oxygenation (ECMO) is an advanced respiratory and circulatory support technique used to treat patients with severe heart or lung failure, acting as the patient's heart and lungs, providing necessary oxygen exchange and circulatory support when traditional ** is ineffective. In short, ECMO is the front-line life support system in critical care medicine.
There are two main modes of ECMO:Veno-vein (VV) and arterial-venous (VA).
vv-ecmo：It is mainly used to support lung function and is indicated for those who have good heart function but severely impaired lung function.
va-ecmo：It supports both heart and lung function and is suitable for patients with heart failure or after heart surgery.
The application of ECMO technology has led to significant survival improvements, but its applicability needs to be carefully evaluated. The key to selecting ECMO** is a comprehensive assessment of the patient's overall condition, expected improvement in quality of life, and potential resuscitation potential. In addition, the patient's age, complications, and pre-existing health are also important considerations.
Although ECMO provides first-line life support for critically ill patients, its high cost, procedural complexity, and potential complications mean that it should only be considered if no alternative** is determined after a comprehensive evaluation. Doctors need to fully communicate with patients and their families, clarify goals, and make rational decisions.
ECMO, as a high-end life support technology, costs tens of thousands of yuan per day, a figure that discourages many families. The cost components mainly include equipment rental, consumables use, professional operation and monitoring, and possible complications. In detail, equipment and consumables cost the lion's share, and high standards of care and monitoring require professional ICU medical staff to work 24 hours a day, which naturally leads to a significant increase in labor costs.
When it comes to the benefits of ECMO, most people immediately think of survival. Indeed, for patients with severe respiratory or heart failure, ECMO is able to provide a buffer period for further progress. But in addition to survival, we should also focus on the improvement of quality of life and the subsequent reduction of costs. The functional status of patients recovered with ECMO support, their ability to return to social and family life, and the economic burden in the long-term process are all important indicators to evaluate the benefits of ECMO.
Although ECMO can save lives at critical moments, the risk of complications cannot be ignored. Bleeding, infection, organ function damage, etc. can all occur during the process, which will have an impact on the patient's recovery and the final effect. Therefore, doctors and patients' families need to fully understand the potential risks of ECMO and make reasonable medical decisions.
When considering the use of ECMO, the patient's age, underlying medical conditions, current health status, and family wishes and financial conditions need to be taken into account. ECMO should not be seen as a panacea, but rather as a medical option in specific situations. The medical team needs to fully communicate with the patient and family to jointly evaluate the feasibility and expected effect of **, so as to avoid excessive financial and emotional burden on the family.
In the process of deciding to use ECMO, the healthcare team and the patient's family also need to consider the long-term effects**. This includes the patient's quality of life, family and social support systems, and possible future medical needs. Rational decision-making should be based on a comprehensive consideration of these factors, not just immediate life extension.