ECMO Treatment in Jaipur | Advanced Critical Care – Apex Hospitals
Advanced ECMO Treatment in Jaipur for Critical Heart & Lung Emergencies
When the heart or lungs fail suddenly, Extracorporeal Membrane Oxygenation (ECMO) can be the bridge between life and recovery. Apex Hospitals, Jaipur, operates one of Rajasthan's most experienced ECMO programmes — with an 80% survival rate in treated cases.
By the Apex Hospitals Clinical Team · Published July 2025
What Is ECMO and Why Does It Matter?
Extracorporeal Membrane Oxygenation — commonly called ECMO — is a life-support technology that temporarily takes over the work of the heart, the lungs, or both, when these organs are too damaged or exhausted to sustain the body on their own. Blood is drawn from the patient, passed through an artificial membrane that adds oxygen and removes carbon dioxide, and then returned to the circulation — all outside the body, continuously, around the clock.
According to the Extracorporeal Life Support Organization (ELSO), ECMO has been used in more than 200,000 patients worldwide, with survival rates improving steadily as centre experience grows. In India, access to ECMO has historically been limited to a handful of tertiary centres — making the availability of this technology in Jaipur critically important for patients across Rajasthan and neighbouring states.
There are two primary configurations: Veno-Venous (VV) ECMO, which supports the lungs while the heart continues to pump, and Veno-Arterial (VA) ECMO, which supports both the heart and the lungs simultaneously. The choice between them depends on the underlying condition and the patient's haemodynamic status — a decision made by the critical care team within minutes of assessment.
When Is ECMO Used? Common Clinical Indications
ECMO is not a first-line treatment — it is deployed when conventional intensive care, mechanical ventilation, and pharmacological support are no longer sufficient to maintain life. Clinicians at Apex Hospitals' ICU and Critical Care department consider ECMO for patients with:
Severe Acute Respiratory Distress Syndrome (ARDS) — including post-COVID lung failure, severe pneumonia, or inhalation injury where the lungs cannot oxygenate blood adequately despite maximal ventilator settings.
Cardiogenic shock — when the heart muscle is so weakened (after a massive heart attack, myocarditis, or post-cardiac surgery) that it cannot pump enough blood to sustain organ perfusion.
Refractory cardiac arrest (ECPR) — ECMO-assisted cardiopulmonary resuscitation in select patients where standard CPR has not restored circulation.
Bridge to transplant or recovery — keeping a patient stable while awaiting a heart or lung transplant, or while the native organ recovers from an acute insult.
Pulmonary embolism with haemodynamic collapse — massive clots in the pulmonary arteries causing acute right-heart failure.
Severe drug toxicity or poisoning — where cardiac or respiratory depression is profound and reversible with time and organ support.
The World Health Organization estimates that cardiovascular diseases account for 17.9 million deaths globally each year, and acute cardiac emergencies represent a significant proportion of ICU admissions in India. Having ECMO capability on-site transforms the survival odds for the most critically ill subset of these patients.
ECMO at Apex Hospitals Jaipur: What Sets the Programme Apart
Apex Hospitals, Malviya Nagar, Jaipur, operates both Veno-Venous (VV) and Veno-Arterial (VA) ECMO machines within its Advanced ICU — one of the most comprehensively equipped critical care environments in Rajasthan. The programme has achieved an 80% survival rate in ECMO cases, a figure that benchmarks favourably against published international outcomes for comparable patient populations.
Key elements of the Apex ECMO programme include:
24×7 ECMO-capable ICU team — intensivists, perfusionists, and cardiac surgeons available around the clock, not just during business hours.
Dedicated Cardiac ICU and Advanced ICU — separate, purpose-built environments for cardiac and multi-organ failure patients, with continuous haemodynamic monitoring.
On-site Hybrid Cath Lab — enabling immediate interventional cardiology support (angioplasty, stenting) alongside ECMO initiation for patients in cardiogenic shock after a heart attack.
CRRT (Continuous Renal Replacement Therapy) — available within the same ICU for patients who develop acute kidney injury while on ECMO, avoiding the need for inter-facility transfer.
Emergency OTs available 24×7 — surgical back-up for ECMO cannulation, decannulation, or concurrent procedures without delay.
NABH Accreditation — ensuring protocols, infection control, and patient safety standards meet national benchmarks.
For patients requiring advanced cardiology care in Jaipur, the integration of ECMO with the Hybrid Cath Lab means that a patient in cardiogenic shock can receive mechanical circulatory support and coronary intervention in a single, coordinated episode of care — without being moved between facilities.
The ECMO Care Pathway at Apex Hospitals
Understanding what happens when a patient is placed on ECMO helps families navigate an intensely stressful situation. At Apex Hospitals, the pathway follows a structured sequence:
Rapid assessment and ECMO eligibility decision — the critical care team evaluates the patient's diagnosis, reversibility of the underlying condition, and contraindications within the first 30–60 minutes of ICU admission.
Cannulation — large-bore cannulas are placed (typically in the femoral or jugular vessels) under ultrasound guidance, usually at the bedside in the ICU or in the emergency OT.
Circuit initiation and titration — the ECMO machine is started, flow rates and sweep gas are adjusted, and the ventilator settings are reduced to allow the lungs to rest (in VV ECMO) or the heart to offload (in VA ECMO).
Daily multidisciplinary rounds — intensivists, cardiologists, pulmonologists, and the nursing team review ECMO parameters, anticoagulation targets, and organ function every day.
Weaning and decannulation — as the native organ recovers, ECMO support is gradually reduced. When the patient tolerates minimal support, the cannulas are removed and the vessels are repaired.
Step-down and rehabilitation — patients transition from the ICU to a monitored ward, and then to the physiotherapy and rehabilitation unit to rebuild strength and function.
ECMO for Respiratory Failure: The VV ECMO Story
Veno-Venous ECMO became globally prominent during the COVID-19 pandemic, when a subset of patients developed severe ARDS that was unresponsive to prone positioning, high-frequency oscillation, and maximal ventilatory support. At Apex Hospitals, VV ECMO was deployed for patients with refractory hypoxaemia — those whose blood oxygen saturation could not be maintained above safe thresholds despite every conventional measure.
Beyond COVID-19, VV ECMO is used for severe community-acquired pneumonia, influenza-related ARDS, post-operative respiratory failure after cardiothoracic surgery in Jaipur, and pulmonary haemorrhage. The key principle is that the lungs are given time to heal — sometimes days, sometimes weeks — while the ECMO circuit maintains adequate oxygenation and carbon dioxide clearance.
ECMO for Cardiac Failure: The VA ECMO Story
Veno-Arterial ECMO is the more complex of the two configurations because it must support both cardiac output and oxygenation simultaneously. It is most commonly used in cardiogenic shock following acute myocardial infarction, fulminant myocarditis (inflammation of the heart muscle, often in young adults), and decompensated end-stage heart failure.
At Apex Hospitals, VA ECMO is initiated in close coordination with the cardiology team in Jaipur. Once the patient is stabilised on ECMO, the cardiologists can proceed with coronary angiography and intervention in the Hybrid Cath Lab — treating the underlying cause of the cardiac failure while the machine sustains perfusion. This integrated approach is what distinguishes a true ECMO centre from a facility that merely owns the equipment.
The HOPE Tele-ICU: Extending ECMO Expertise Beyond Jaipur
One of the most distinctive aspects of Apex Hospitals' critical care infrastructure is the HOPE Tele-ICU Command Centre — a 24×7 remote monitoring and consultation platform that connects 18 partner hospitals across Rajasthan to Apex's senior intensivists in Jaipur. Featured in the Harvard Business Review and recognised at the GovConnect Conclave for HealthTech Excellence, the HOPE programme allows rural and semi-urban hospitals to access expert ECMO guidance and critical care consultation in real time.
For patients in districts without ECMO capability, the HOPE network enables early identification of candidates who need transfer to Apex Hospitals Jaipur — reducing the time from deterioration to ECMO initiation, which is one of the most critical determinants of outcome. The programme has been estimated to reduce patient cost burden by ₹40,000–₹50,000 per day by preventing unnecessary transfers and enabling appropriate step-down care remotely.
This innovation, supported by a USAID Grant and developed in partnership with the Indian School of Business (ISB), reflects Apex Hospitals' commitment to making super-specialty critical care accessible — not just to patients who can reach Jaipur, but to those who cannot. Learn more about the ECMO programme at Apex Hospitals.
Risks, Complications, and Honest Expectations
ECMO is a high-intensity intervention with real risks, and families deserve a clear-eyed understanding of what it involves. Common complications include bleeding (because patients must be anticoagulated to prevent clotting in the circuit), infection at cannula sites, limb ischaemia in femoral VA ECMO, and neurological events. The Apex critical care team monitors for these complications continuously, using dedicated nursing ratios and daily laboratory surveillance.
Not every patient placed on ECMO will survive — and not every patient who presents in critical condition is an appropriate ECMO candidate. The decision to initiate ECMO involves careful consideration of the underlying diagnosis, the likelihood of recovery or transplant eligibility, the patient's prior functional status, and, where possible, the patient's and family's values and wishes. The Apex team includes this conversation as a structured part of the ECMO initiation process, not an afterthought.
For patients who survive ECMO and are discharged, the journey continues. Many require extended physiotherapy and rehabilitation to recover muscle strength, respiratory endurance, and cognitive function — all of which can be affected by a prolonged ICU stay.
Frequently Asked Questions About ECMO in Jaipur
How long can a patient remain on ECMO?
Duration varies widely depending on the underlying condition. Patients with ARDS may be on VV ECMO for 1–4 weeks while the lungs recover. Patients in cardiogenic shock may need VA ECMO for days to weeks, or until a longer-term device or transplant is arranged. There is no fixed upper limit, but prolonged ECMO carries increasing risk of complications, and the team reassesses goals of care regularly.
Is ECMO available 24 hours a day at Apex Hospitals Jaipur?
Yes. The Advanced ICU at Apex Hospitals Malviya Nagar operates around the clock with ECMO-trained intensivists and perfusionists on duty at all times. Emergency OTs are also available 24×7 for cannulation procedures.
Can ECMO be used for children and newborns?
Neonatal and paediatric ECMO is a specialised sub-field. Families should speak directly with the clinical team about paediatric eligibility. The paediatrics and child care team at Apex Hospitals works in close coordination with the critical care unit for complex cases.
Does insurance cover ECMO treatment?
Apex Hospitals is empanelled under Ayushman Bharat and major insurance and TPA schemes. Coverage for ECMO varies by policy and insurer. The hospital's billing and insurance team can assist families in verifying coverage and processing claims before or during treatment.
What is the survival rate for ECMO patients at Apex Hospitals?
Apex Hospitals has achieved an 80% survival rate in ECMO cases — one of the strongest ECMO outcomes reported in Rajasthan. Survival depends significantly on the underlying diagnosis, the patient's age and comorbidities, and the speed of ECMO initiation after deterioration.
How do I transfer a critically ill patient to Apex Hospitals for ECMO?
Apex Hospitals operates equipped ambulance services for inter-facility transfers. Referring physicians can contact the hospital directly at 098290 30011 to speak with the on-call intensivist and arrange a safe, coordinated transfer. The HOPE Tele-ICU network also facilitates remote pre-transfer assessment for partner hospitals across Rajasthan.
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Is a loved one in critical condition? We are here to help.
If you have a family member who may need ECMO or advanced critical care support in Jaipur, reach out to the Apex Hospitals team — our intensivists are available 24×7 to guide you through the next steps.