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ECMO program celebrates 25 years of saving lives

Nov. 20, 2014, 8:30 AM

Easton Cunningham plays with his father, Chad, during the reunion event celebrating the 25th anniversary of Vanderbilt’s extracorporeal membrane oxygenation (ECMO) program. (photo by Rex Perry)

For 25 years, patients at Monroe Carell Jr. Children’s Hospital at Vanderbilt, like 20-month-old Easton Cunningham, have been given a second chance at life when their lungs or heart, or sometimes both, have failed to perform.

Easton, a rambunctious toddler who loves toy cars and balls, is one of 955 patients who have received extracorporeal membrane oxygenation (ECMO) at Children’s Hospital since November 1989.

The ECMO team held a 25th anniversary reunion on Saturday, Nov. 15, to celebrate the patients, including Easton, who have been helped through the years. About 250 patients and their families attended the event.

The names, faces and stories are different. But they all shared that moment of uncertainty, an uncertainty if their loved one would make it past their illness or injury.

At last weekend's event, Eli Herman plays with a demonstration version of the ECMO pump that saved his life. (photo by Rex Perry)

For his first month of life, Easton’s parents, Kerry and Chad, weren’t sure they would ever get to enjoy his energy and enthusiasm for life. During birth at a local hospital, Easton inhaled meconium (a newborn’s excrement) while still in the womb and was suffocating. His mother had an emergency cesarean section. Easton couldn’t breathe and needed nitric oxide, not available at the hospital where he was born.

Given the choice of a hospital, the Cunninghams, who live in Murfreesboro, Tennessee, wanted Easton transported to Children’s Hospital.

“He was swollen and blue. It’s probably one of the scariest things I had ever seen,” said Kerry Cunningham.

He was put on ECMO that artificially oxygenates the blood through a machine, then pumps the oxygenated blood back into the body either through the arteries or veins.

The mobile machine is used both in and outside the operating room and can support vital heart and lung function for weeks at a time until the organs can recover, or sometimes until a heart transplant is available.

Easton spent five days on ECMO. Today, he is a happy, healthy and very active toddler. “He likes to run and run — non-stop,” chuckled his mother, Kerry, with emphasis on “non-stop.”

The ECMO program at Children’s Hospital is one of the largest and most successful in the world. For the past seven years, it has received recognition as a Center of Excellence from the international consortium Extracorporeal Life Support Organization (ELSO), earning the ELSO Award for Excellence in Life Support.

The award is given to programs that show a commitment to exceptional patient care, have a high level of quality standard including specialized equipment and supplies, defined patient protocols and advanced education of all staff members.

Asked what makes the ECMO program at Children’s Hospital so successful, John Pietsch, M.D., replied simply: “The people.

“We’ve got a great team. It’s truly a team—we have neonatology, pediatric intensive care, the pediatric cardiac team, adult trauma team and adult intensive care, who work closely with the ECMO team, not to mention all the nurses and the respiratory therapists and everyone else. It works because we’ve got all these people working together,” said Pietsch, surgical director and founder of the ECMO program at Vanderbilt. “The equipment has also gotten better and we know which patients ECMO is best for.”

Pietsch arrived at Vanderbilt in 1986 from Louisville, Kentucky, where he had been a part of an ECMO team. He convinced Vanderbilt to start an ECMO program, and prepared for the right child to be the first patient. Chelsea Brown arrived at Vanderbilt Nov. 24, 1989, and was the first-ever ECMO patient at Vanderbilt and in Tennessee. Like Easton, she had inhaled meconium and was unable to breathe. Today, she is 25 and is a college graduate living in Boston.

For Pietsch, the reunions are a defining moment in which he gets to see the results of his teams’ work.

“You get to see patients you haven’t seen for some time. It’s very satisfying for us to see all the successes,” he said.

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