Children's ECMO program provides critical time

Quaneisha Driver was running out of time. Her heart was so weak in December 2005 that only a transplant could save her, and Children's — the only pediatric facility in North Texas with a successful history of heart transplants — was one of her final options.

Though she was on life support at another local hospital at the time, Driver could be moved to Children's because of extracorporeal membrane oxygenation (ECMO). Working in conjunction with a team from the other hospital and Wilford Hall Medical Center in San Antonio, Driver was transported to Children's. A heart was found days later, and doctors conducted transplant surgery on Dec. 25 — just in time for Christmas.

"If we didn't have an ECMO program like this, then we couldn't have brought her here and have had the opportunity to get her a heart," said Dawne Black-Wieber, clinical manager of the Children's ECMO program.

Saving Lives

The pediatric ECMO program at Children's, the only one available in the Dallas area, has administered life-saving support to more than 400 patients since 1990. That includes 30 patients in 2006, 16 for pulmonary disease and 14 for cardiac support.

The ECMO machine is three parts working together to properly oxygenate a patient's blood: a pump (artificial heart), an artificial lung and a blood warmer. The machine takes the blood without oxygen, the "blue" blood from the right side of the heart, and pumps it through the artificial lung, the oxygenator. Once the blood is oxygenated, or "red," it is warmed before returning to the patient.

At the start of the ECMO procedure, the machine performs most of the work for the patient's heart and lungs, allowing them time to rest and recover function. A ventilator helps the patient breathe.

An increase in the oxygen level of the blood indicates the lungs are healing. Progressively, the ECMO machine is lowered until it is only responsible for a small portion of the heart and lung's work.

Seven ECMO specialists are available 24 hours a day, seven days a week.

"If a patient arrests in the hospital with a disease process that is thought to be reversible, we can get the patient on ECMO within 20 minutes," said Dr. Marita Thompson, medical director of the ECMO program and assistant professor of Pediatrics at UT Southwestern. "Time is of the essence in cases like these. Having a core team means so much and is something not many hospitals can attest to."

Resources

Children's Medical Center

Tags: heart , ECMO , The Heart Center , heart transplant