의료진의 노력과 '에크모'가 있다면💖적은 확률이라도 포기란 없다❌- [나는의사다 961회]

Summary

The episode explains what ECMO does, when it may be used, and why it is not suitable for every critically ill patient. Professor Jeong Eui-seok, a thoracic and cardiovascular surgeon, also discusses developing patented medical devices and the intensive staffing ECMO care requires.

The guest’s background and inventions

Professor Jeong says he studied engineering before medical school and later drew on that background in his work as a surgeon. He describes developing patents for devices including an ECMO catheter connector, an aortic balloon-related device, and a vascular drainage device. These inventions grew out of practical problems he encountered while treating patients.

What ECMO does

ECMO, or extracorporeal membrane oxygenation, temporarily supports the heart and/or lungs. It moves blood outside the body, adds oxygen, and returns the blood to the patient. This can give a severely ill patient’s heart or lungs time to rest and potentially recover.

Unlike the more complex heart-lung machines used during surgery, ECMO is designed for longer-term support. Professor Jeong describes it as a simplified, improved system—not simply a machine with functions removed.

ECMO is also different from kidney dialysis. Dialysis filters waste from the blood, while ECMO adds oxygen to support breathing and circulation.

The demands of ECMO care

ECMO care requires more attention and personnel than routine intensive-care treatment. Teams may include specialists such as respiratory and digestive-system physicians, as well as extracorporeal-circulation professionals. Staff must monitor patients continuously and work in shifts, particularly when treating patients with infectious diseases.

Outcomes and the possibility of recovery

ECMO is generally considered for patients who would otherwise face a very high risk of dying, and outcomes can be poor. To illustrate, Professor Jeong describes a hypothetical group of 100 patients: around half might be taken off ECMO, and about half of that group might return to everyday life—roughly one-quarter of the original group. These figures are illustrative, not a guarantee for any individual patient.

Some patients have required ECMO for more than 100 days. Although prolonged use is difficult, advances in care and sustained work by medical teams have helped some patients survive, including some who later received lung transplants.

The episode’s central message is that even a relatively small chance of recovery may be worth pursuing, and medical teams work to improve those chances.

ECMO capacity and equipment sharing

Professor Jeong gives figures from the time of the discussion: roughly 400 ECMO units nationally, including 58 units purchased by the government the previous year. He says units had been transferred between hospitals when needed, describing about nine transfers and one patient who benefited.

When ECMO may not be appropriate

ECMO is not suitable for everyone. Very elderly patients may have poorer outcomes, and bleeding risk can make treatment unsuitable because medication used to prevent clotting may worsen bleeding.

Professor Jeong emphasizes that the decision should depend on whether there is a meaningful prospect of benefit. The episode also acknowledges that clinicians may keep trying in difficult cases rather than give up prematurely.

Speakers and sources featured

• Host(s) of I Am a Doctor — Introduce the guest and ask questions; their names are unclear in the subtitles.
• Professor Jeong Eui-seok — Thoracic and cardiovascular surgeon at Kangbuk Samsung Hospital, discussing ECMO and his clinical and device-development experience.