171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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Technological lifesaver
By Jill Coley
September 29, 2008
The Post and Courier
About 15 years separate patients Lauren Hatchell and newborn Abbie Barron.
Both are alive today thanks to a lifesaving device called extra- corporeal membrane oxygenation, or ECMO. A dramatic effort to save lives, ECMO literally turns patients inside out.
Lauren's mother was so touched by her daughter's brush with death that she went on to become a registered nurse and one of 21 ECMO specialists at the Medical University of South Carolina.
Among her most recent patients was newborn Abbie, who finally breathed on her own on Wednesday night.
ECMO is a network of small machines, tubes and pumps that is a last resort for patients whose lungs and hearts are failing. Thick catheters divert blue blood from the body into an artificial lung, where the blood blossoms red with oxygen. The blood then is warmed and pumped back into the body.
Lauren was among MUSC's earlier ECMO patients in 1993. When she was born, she could not breathe because her lungs would not relax and allow air in. She was given a less than 10 percent chance of surviving.
Doctors told Lauren's mother, Lynn Oomens, about a new treatment called ECMO, and within hours her daughter was hooked up to the bypass machine.
"There is no preparation to walk in and see what it is," she said. "But as invasive as ECMO is, as dangerous as it is, and as much of last resort — it really lets this baby rest."
Lauren was weaned from the device after four days and has thrived ever since. Today, she is a theater student at the Charleston County School of the Arts, and the only physical evidence of her time on ECMO is a 1/2-inch scar on her neck.
But the experience lingered with Oomens.
"I thought of the moment the nurses took her off ECMO," she said. "I wanted to look at parents and say, your baby is going to be OK."
She went to nursing school and eventually became an ECMO specialist, now working alongside those who saved her daughter's life.
Robert Bartlett, a surgeon with the University of Michigan Health System, developed the technology in the mid-1970s. Within 10 years, more than 700 newborns had been treated with an 80 percent success rate.
Dr. Dilip Purohit, medical director for MUSC's ECMO program, which marked its the 20th anniversary this year, said that although the technology has been improved upon over the years, the device remains largely the same.
The biggest change is that the application of the technology has grown to include children and adults. ECMO was originally developed to take care of newborns with reversible lung disease when conventional care fails and there is a high risk of the baby dying.
Over the years, the program expanded to older infants and children and eventually to adults. The device also is used as a bridge to transplant for those who need new hearts.
MUSC has treated 333 patients with ECMO — 213 newborns, 86 children and 34 adults. Newborns have the highest survival rate — 80 percent. Pediatric and adult survival rates are 60 percent and 50 percent, respectively.
"Babies are much more resilient," Oomens said. As people get older, they develop other conditions that can increase their risk for complication.
Risks for ECMO include blood clots, brain bleeds, embolisms, or air bubbles, and infection, all of which increase the longer a patient remains on bypass. Patients are usually on ECMO for about five days but can remain on the device for as long as 30 days.
MUSC has three ECMO units and can treat patients of any age. Palmetto Richland Memorial Hospital in Columbia also has an ECMO device that treats babies. And Trident Hospital can treat adults with ECMO for up to 48 hours, hospital officials said.
Oomens works the night shift in the neonatal intensive care unit at MUSC. Working during the quieter hours allows her to "be a nurse to the parents as well," she said. On Wednesday night, Oomens had another chance to tell a family that their baby will be OK.
When Abbie Barron was born Sept. 17, she was not breathing. Doctors found a hole in one of her lungs, and after trying a number of failed interventions, Abbie was attached to ECMO.
Her father, Joseph Barron, said "I had to be the strong one for my wife." This was the second time Barron lived the trauma of having a newborn on ECMO.
Five years ago, his daughter from his previous marriage suffered potentially fatal complications after inhaling meconium, which is the first stool passed in the womb.
Abbie still has hurdles to pass, such as learning to eat after being on a feeding tube, Barron said. In the meantime, he and his wife, Mary, spend every hour possible alongside Abbie's bed.
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