Saving lives at Children's for over 20 years
Children's Hospital Boston has employed extracorporeal membrane oxygenation, or ECMO, to save lives for more than 20 years. A mechanical support, ECMO temporarily acts as a patient's heart and lungs while he recovers from an underlying condition. It is comprised of an intricate circuit in which a portion of the patient's blood is removed through a tube, flowed through the ECMO machine—where it is enriched with oxygen—and pumped back into the body.
In 1984, Children's was the sixth hospital in the country to launch an in-house ECMO program, and has placed more than 850 patients on the support since the program's inception. ECMO is typically used in critically ill patients who haven't responded to standard advanced life support to help with their breathing and circulation until a longer-term solution can be found. It's the most widely used form
of mechanical heart-lung support in infants and children.
Over the years, ECMO has been applied to a number of conditions at Children's—from congenital diaphragmatic hernia (a birth defect in which an infant's diaphragm doesn't fully develop) and persistent pulmonary hypertension (a condition that occurs when a newborn's circulatory system doesn't adapt to breathing outside the womb) to cardiac failure.
Today, the technology is even used during acute resuscitation, thanks to the hospital's ECMO Rapid Response program, which was established in 1996, and was one of the first of its kind instituted nationwide. As part of Rapid Response, an ECMO circuit stands ready at all times in the cardiac intensive care unit, and an ECMO specialist is on call 24 hours a day, seven days a week. "We can place a patient on ECMO within 30 minutes," says Nancy Craig, RT, ECMO specialist and manager of Children's Respiratory Care Program. Fifteen to 20 of the hospital's ECMO cases are initiated through Rapid Response ECMO during acute resuscitation each year.
Children's ECMO program remains the busiest on the East coast, supporting an average of 50 patients annually, and maintaining six ECMO machines—more than any other hospital in New England.