Photo by Dana Johnson
ECMO changes set VCH apart
A change in the equipment used in the Extracorporeal Membrane Oxygenation (ECMO) program at the Monroe Carell Jr. Children's Hospital at Vanderbilt may help set the hospital apart as one of the most advanced ECMO facilities in the nation.
Over the last several months, a unique combination of internal parts and tubing — coated with the blood thinner heparin — has been installed in the machines.
“We made the move to this equipment initially for heart surgery patients. About 7 percent of children who have heart surgery end up going on ECMO after surgery,” said Randy Bartilson, manager of the ECMO program. “Complications on ECMO include a high risk of bleeding, so typically you have to be on a lot of heparin to keep the blood flowing through the ECMO machine without clotting.”
Bartilson said the goal of using the heparin-infused tubing and parts is to delay using heparin in the patient's body just long enough after surgical procedures to allow the body to stop bleeding naturally.
“That's usually within about 12 hours, and now with the new system, we routinely go 12 hours without heparin,” Bartilson said.
The ECMO specialists have documented a decrease in bleeding, reduction in blood product usage, and fewer clotting issues in the ECMO circuit.
“I get calls from other ECMO programs trying to get this system up and going in their institutions. This has been a fun project to work on, not only because of the impact it is having on our patients here, but because it can make a significant difference for children all over the U.S.,” Bartilson said.