BWH’s Critical Care Forum regularly brings together clinicians from the multidisciplinary team to share different perspectives on important critical care topics. The most recent forum on June 11 focused on a patient care process that requires especially intensive collaboration: extracorporeal membrane oxygenation, also known as ECMO.
A specialized intensive care technology that is used when a patient’s lungs or heart aren’t working on their own, ECMO is a groundbreaking method that provides hope for the sickest cardiovascular and pulmonary patients. Patients who are in respiratory failure, awaiting or recovering from a heart or lung transplant or suffering from temporary, life-threatening conditions may be candidates for ECMO. The ECMO machine acts as a lung to deliver oxygen into a patient’s blood, keeping the patient stable and eventually enabling them to recover and breathe on their own. ECMO was first pioneered by Robert Bartlett, MD, a graduate of BWH’s surgical training program, while he was a fellow at BWH and Children’s Hospital.
In the past two years, ECMO has saved the lives of more than 50 patients. In 2014, BWH ranked in the top fifth percentile in the nation for survival rate of both cardiovascular and respiratory patients treated with ECMO.
“This extraordinary accomplishment is no small feat, particularly given that the average person who is treated with ECMO has a mere 20 percent chance of survival,” said Phillip Camp, MD, co-director of the BWH ECMO program, during the forum.
The process requires expert input from disciplines including nursing, anesthesiology, respiratory therapy, hematology, surgery, pulmonary, cardiology, pharmacy and others. Additionally, any patient receiving ECMO must be surrounded by six patient care professionals at all times—four nurses and two respiratory therapists.
“At the beginning, we had so many questions about ECMO,” said Lindsay Blacquier, RN, of Tower 11C, the Thoracic ICU. “It’s rewarding to look back and see how far we’ve come in two years.”
Peter Burrage, MD, PhD, a critical care fellow in the Department of Anesthesiology, Perioperative and Pain Medicine, also gave an overview of some recent advances, including how the care team uses trans-esophageal echocardiography (TEE)—a type of heart ultrasound—in conjunction with ECMO.
“TEE allows for real-time visualization of the heart and can help the care team safely deploy the ECMO circuit, monitor patient recovery and quickly detect complications for patients on ECMO,” said Burrage.
Cindy Scribner, whose life was saved by ECMO last year, joined care providers at the forum and shared her perspective as a patient.
Scribner was diagnosed with idiopathic pulmonary fibrosis, a disease that causes scarring in the lungs and in her case, led to lung failure. ECMO took over the work of breathing for her while she waited to receive a lung transplant at BWH.
“The nurses and doctors at BWH were always there for me and made me feel very special,” said Scribner, who attended the forum with her husband and three small children. “I’m very thankful for their care and wouldn’t be alive today if it weren’t for ECMO.”
Today, Scribner is healthy and strong, and enjoying her time at home with her family, whom she credits with helping to keep her stay positive during her treatment.