How ECMO Helps UF Health Care for the Most Complex Patients

Critical care is one of the most important parts of a hospital because it’s dedicated to caring for the sickest patients and providing constant monitoring, specialized treatment and life-saving support when every second matters.

Critical care teams can provide patients with access to advanced technology and life-support equipment, such as ventilators, dialysis machines, and ECMO, along with highly specialized physicians, nurses, and respiratory therapists who work together to stabilize and treat them.

When it comes to treating critical care patients, no machine is more important than Extracorporeal Membrane Oxygenation (ECMO). The machine temporarily takes over the function of the heart and or lungs when a patient’s organs are too weak to properly function on their own. It gives the body precious time to rest and recover from serious conditions like heart failure, serious lung disease, or complications from infection or trauma, when standard treatments are no longer enough.

To explain the impact and importance of critical care at UF Health, Doug Kirk, ECMO coordinator, sat down with us to explain this life-saving technology and why it matters so much for our community.

What is an ECMO machine

Think of ECMO as an external artificial heart and lung system. It takes blood out of the body, adds oxygen to it, removes carbon dioxide, and then pumps the refreshed blood back into the patient. This allows the patient’s real heart and lungs to rest and heal while the machine keeps the body supplied with oxygen-rich blood. It’s a highly advanced form of life support.

Who determines if someone needs ECMO?

The decision starts with the patient’s admitting doctor. If they believe ECMO might help, they consult the ECMO team. The ECMO physicians then carefully evaluates the patient to see if they meet the right criteria. The goal is to help people with reversible conditions – situations where the body has a chance to recover.

How is collaboration among disciplines important to ensure the ECMO care is successful for the patient?

It is extremely important because ECMO is a team sport. It requires close coordination between intensivists, heart surgeons, cardiologists, nurses, respiratory therapists and perfusionists[AL1] [AL2] [DK3] . Each group has a piece of the puzzle in the care of these patients. Once a patient is on ECMO, the team is essentially caring for two patients -- the ECMO machine and the patient that's connected to it. So, you must have all those specialists to know the pieces and how they interact together safely.

How do patients benefit from ECMO?

ECMO buys critical time to treat the patient. It serves as a “bridge” to:

• Recovery
• Transplant
• Or a more permanent support device

At UF Health we focus on bridge to recovery. Using ECMO and our medical expertise to keep patients close to home and avoid the need for escalation to transplant or other permanent devices. Without ECMO, many of these patients would not survive long enough to heal or receive further treatment.

How long are patients usually on ECMO?

It varies widely from patient to patient. Some patients recover in as little as 24 hours, while others may need it for weeks or months. There is no one-size-fits-all timeline. Recovery depends on the patient’s injuries and how they respond to treatment. Our advanced lung rescue care allows us to cut the national benchmark for time on ECMO in half. In some cases, it allows us to avoid the need for ECMO for lung failure entirely.

How do doctors know when a patient is ready to come off ECMO?

The team watches closely for signs that the patient’s heart or lungs are getting stronger and starting to work on their own again. For example, if a patient’s heart was too weak to pump effectively and needed time to recover, we monitor for signs that the heart is now pumping more blood on its own. The same approach applies to patients whose lungs needed ECMO support. We check to see if the lungs are able to exchange oxygen and carbon dioxide on their own. As improvement is seen, doctors slowly reduce the machine’s support. Before removing ECMO completely, patients go through “weaning trials” – careful tests to make sure their heart and lungs can handle working without the machine.

What are some common misconceptions about ECMO?

ECMO fixes everything

ECMO is not a time machine, nor a magic wand, though at times it can seem like both. At its core, ECMO is a pause. A bridge through the storm. It gives the body time for infection to clear, for the heart or lungs to recover, or for clinicians and families to better understand the road ahead after devastating injury or illness. Sometimes, time itself becomes part of the treatment. And sometimes, despite every effort, it is not enough.

ECMO is for everyone

That reality is why ECMO is approached with such reverence and caution. Patient selection and stewardship of this therapy are taken extraordinarily seriously. ECMO is among the most resource-intensive and ethically complex therapies in modern medicine, and its use demands both humility and discipline.

Why is ECMO important for our hospital and community?

Having ECMO capability allows UF Health Jacksonville to care for the most complex cases right here – including trauma, heart issues, and severe lung problems. Without it, we’d have to transfer many critically ill patients to other hospitals, delaying care and reducing our ability to serve our community. ECMO at UF Health helps us keep families close to home while providing world-class treatment.

ECMO isn’t just a machine – it’s a second chance for patients facing life-threatening illness. Thanks to dedicated teams like ECMO and the entire critical care staff at UF Health, more patients are getting the care they need to heal and return to their loved ones.

If you or a family member ever need advanced critical care, know that UF Health is prepared with some of the most advanced support available.