November 15, 1996

Gathering brings back children treated through VUMC’s ECMO program

Gathering brings back children treated through VUMC's ECMO program

More than 20 of the 97 newborns and children treated through Vanderbilt University Medical Center's ECMO program reunited recently with the faculty and staff who helped them survive.

VUMC is one of 96 medical centers in the country using ECMO – Extra Corporeal Membrane Oxygenation, a heart/lung bypass procedure which uses a perfusion pump to allow blood from an infant or child's lungs to oxygenate outside the body. Only one other medical center in Tennessee can do the ECMO procedure. Of the three ECMO beds in the state, two are at VUMC.

"People who go on ECMO usually have an 80 percent chance of dying without it," said Sue Hix, ECMO nurse coordinator. "With ECMO, at this institution and nationwide, we have a 75 percent survival rate. We're able to save the bulk of these patients."

About 70 percent of ECMO patients at VUMC have been infants; the other 30 percent have ranged in age from one to 14. Some medical center also treat adults with the procedure.

Patients come mostly from Middle Tennessee, but some have come from other states including Kentucky, Mississippi and Alabama.

VUMC began offering ECMO for critically ill infants seven years ago. The first child to be treated was Chelsea Brown, now a seven-year-old first-grader in Hendersonville.

"We're starting to get pictures back from our ECMO kids who are now in kindergarten and first grade. Having them here for the reunion just gave us another opportunity to hug them and to get to see the families again. It was wonderful," Hix said.

Many of the children who were on ECMO were born with meconium (matter from an infant's first bowel movement) in their lungs and developed a form of pneumonia. "Some were also born with very profound infections," Hix said.

"What happens is their lungs revert back to fetal circulation again and don't adapt to breathing. We call it 'shutting down.

"It takes a lot of drug attention and intervention with a ventilator to try to get the lungs to open back up again," Hix said. "That can cause a lot of damage to the lungs and the infants can end up with scarred lungs that can cause a lot of problems down the road.

"With ECMO the lungs are bypassed altogether. Blood flows out of the body into the artificial lung, where it is oxygenated. Carbon dioxide is removed before it is returned to the blood vessels. This gives the child's lungs a chance to heal or to mature."

Lung problems aren't the only reason for using ECMO. Some with heart problems are often candidates. The technique is used following heart surgery when the child can't be weaned from bypass. Children have remained on the ECMO pump for as long as 19 days here at Vanderbilt.

Hix said that children who are treated with ECMO today are generally in poorer health than those seven years ago.