Treating pulmonary and cardiac failure
Heart and lung support bundles our treatments for patients suffering from pulmonary and/or cardiac failure. Working from one single platform that combines both heart and lung support, we offer a variety of different treatment options. These are based on the principle of extracorporeal membrane oxygenation, or short ECMO.
ECMO is an established form of extracorporeal life support (ECLS). It provides cardiopulmonary support in critically ill patients when conventional measures fail (e.g. mechanical ventilation, inotropes or other cardioactive drugs, etc.).1
Put simply, ECMO therapy bypasses the function of the lungs. The patient's blood is withdrawn from the body via cannulas and regulated with the support of a pump. Outside the body the blood is freed from carbon dioxide (CO2) and enriched with oxygen (O2) in a gas exchanger – a so-called artificial lung. The blood then re-enters the body through a second cannula.2
ECMO as a rescue measure is indicated, for instance, in the therapy support of severe Acute Respiratory Distress Syndrome (ARDS) with refractory hypoxemia, or in refractory cardiogenic shock (CS). These are not the only critical situations in which ECMO is used, yet are the most common as described in literature.1,2
The full spectrum of ECMO support
With our product offering, we support the full spectrum of extracorporeal cardiopulmonary treatments: From partial CO2 removal to full oxygenation3,4, from low to high blood flows and from pediatric patients up to adults.
Different cannulation strategies define the type of ECMO treatment
There are two basic ECMO modes that are used, depending on which organ in the body needs support: veno‑arterial (VA) and veno‑venous (VV). VA ECMO is the treatment when both heart and lungs need support, while VV cannulation is chosen when only respiratory function needs support.
- Supports mainly the lungs (respiratory functions)
- Drains blood from a major vein and returns it to a major vein
- Adequate circulation is provided by the native cardiac output
- Supports heart and lung (circulatory and respiratory functions)
- Drains blood from a major vein and returns it to a major artery
VA ECMO with synchronized cardiac support
An innovative VA ECMO treatment is our synchronized cardiac support (SCS). The vision of SCS is to bridge the gap between physiology and mechanical circulatory support by adapting to the patient’s heart rhythm via an ECG-triggered pulsatile flow.*
*Clinical trials to generate evidence for synchronized cardiac support treatment are scheduled. Data from preclinical studies is available.
Extracorporeal carbon dioxide removal (ECCO₂R)
Extracorporeal carbon dioxide removal (ECCO2R) is a form of ECLS that provides lung support by eliminating excess carbon dioxide (CO2) from the blood. In contrast to ECMO, ECCO2R works with lower blood flows where no significant blood oxygenation takes place.
ECCO2R aims to prevent ventilator-induced lung injury by allowing more lung protective ventilatory settings or to correct respiratory acidosis in patients with acute hypoxemic or hypercapnic respiratory failure.5
ECLS with Xenios console
These different ECLS treatments for heart and lung support can all be performed with the Xenios console – a multifunctional and modular system. This technology enables versatile application. The Xenios platform works with a range of various patient kits depending on the intended treatment.
- For ECMO treatments with advanced mode applicable from neonates up to adults
- From partial CO2 removal to full oxygenation3,4
- VV, VA ECMO applications
- ICU, operating room, cardiac catheterization lab
An ECLS system includes cannulas for vascular access, a blood pump and an oxygenator for gas exchange.
Besides this basic setup, the MultiSupport GROUND (MSG) - our ground transport solution - enables inter-hospital transport of severely ill patients undergoing extracorporeal heart and lung support.
Learn more: www.xenios-ag.com
1 Brogan TV et al. Extracorporeal Life Support: The ELSO Red Book (5th edition) 2017
2 Sangalli F ECMO-Extracorporeal Life Support in Adults 2014; 19-36
3 Redwan B et al. Interact Cardiovasc Thorac Surg 2015; 21:766-772
4 Braune S et al. Intensive Care Med 2016; 42(9):1437-1444
5 Combes A et al. Intensive Care Med 2022; doi: 10.1007/s00134-022-06796-w