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Critically ill eastern N.C. children, adult patients benefit from life-saving program at Vidant Medical Center

April 13, 2015 by Kathy Neal

Critically ill children in eastern North Carolina are benefitting from a life-saving program now available at Vidant Medical Center: extracorporeal membrane oxygenation, or ECMO [ECK-moe]. 

ECMO circulates a patient’s blood through a bedside machine that filters out carbon dioxide and adds oxygen, then returns it to the body – without the lungs having to work. It can also take over the heart’s function of pumping blood throughout the body, supporting both the heart and lungs and allowing them time to recover.

Five pediatric patients with severe lung and/or heart problems have received ECMO treatment at the James and Connie Maynard Children’s Hospital at Vidant Medical Center. For example, several have had severe lung infections and were put on ECMO in the Pediatric Intensive Care Unit (PICU) to support their lungs while antibiotics and round-the-clock care treated the infections. Three of those patients are now home. 

The service is also provided for adults. VMC is the only North Carolina hospital east of I-95 to offer ECMO to both children and adults.

“We are very pleased to be able to offer ECMO to our patients,” said Dr. David Rodeberg, pediatric surgeon in chief at the Children’s Hospital and professor and chief of pediatric surgery at ECU’s Brody School of Medicine. “It means we can keep many of our patients closer to home, rather than referring them outside of eastern North Carolina, and we can improve the outcomes for some of our sickest patients.”

“ECMO allows us to support our young patients before and after surgery and during aggressive treatment for infection,” said Dr. Matthew Ledoux, co-medical director of the Children’s Hospital and chief of pediatric critical care at ECU’s Brody School of Medicine. “It can and does save lives.”

“ECMO is a vital option for us to have for those children who have significant lung or heart problems,” said Dr. Koh Takeuchi, pediatric cardiothoracic surgeon and clinical associate professor with the Department of Cardiovascular Sciences at East Carolina Heart Institute at ECU. 

Barbara Batts, assistant vice president for Women’s Services and the Children’s Hospital, emphasized the importance of offering ECMO for young patients. “This gives us a more comprehensive approach to serving the needs of critically ill children.” She also acknowledged the key role of respiratory therapists and critical-care nurses in supporting pediatric ECMO patients. “It is a very intensive team effort,” she added. 

Adult and pediatric patients with severe lung or heart injuries due to trauma are also candidates for ECMO, as are those awaiting lung or heart transplants, procedures that would take place outside the region.

“Adding ECMO to our services is a major step forward for our adult patients with severe cardiac and pulmonary problems,” said Dr. Nathaniel Poulin, critical care surgeon at VMC and clinical assistant professor of trauma and surgical critical care at ECU’s Brody School of Medicine. “We see a lot of congestive heart failure in eastern North Carolina, and using ECMO can make a real difference in helping these patients while we address the underlying cause of the problem.”

The ECMO team consists of surgeons, intensive care and trauma physicians, ECMO specialists, nurse practitioners, nurses and respiratory therapists. Team members developed the program over two years, undergoing rigorous training and conducting extensive simulation lab testing before the first patient was treated. All national guidelines and best-practice protocols have been implemented within the service. 

ECMO was first introduced in the 1980s as a solution for premature infants whose immature lungs didn’t function properly. Today, the technology is used for both pediatric and adult patients. As with most medical procedures, ECMO does have risks, which are carefully explained to patients and families. 

But, for the pediatric patients who have gone home after ECMO, the outcome has been exactly what the team hoped for: very sick children now on the way to healthier childhoods.
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