ECMO Brings a New Level of Care to Wolfson Children's Hospital

Jacksonville, Florida, April 23, 2007 -- North Florida babies and children now have access to a new level of care and may be able to stay closer to home when their hospitalization requires the extra support of the lungs and/or heart with the addition of extracorpeal membrane oxygenation (ECMO) therapy to the comprehensive medical and surgical services of Wolfson Children's Hospital.

ECMO is a form of heart-lung bypass that can be used for long-term support of the lungs and/or heart following a critical illness or surgery. Unlike traditional heart-lung bypass support, ECMO can be used for seven to 10 days as opposed to hours. Wolfson's new program is one of eight ECMO programs in the state.

ECMO equipment is comprised of a catheter, inserted into one or more large veins in the child's body by a pediatric surgeon to withdraw blood; a membrane oxygenator; and a circuit. The catheter transports unoxygenated blood to a pump that acts as the child's "heart." The blood is pumped through a membrane where it is oxygenated and rewarmed by a heater, then returned to the body via the catheter. ECMO takes the load off the heart and lungs, allowing the body's natural healing process to work more efficiently.

Venoarterial ECMO can be used to bypass both the heart and lungs to take the load off the heart through bypassing heart function. In venovenous ECMO, a child may have a healthy heart but poor lung function; in this case, the blood is oxygenated using the circuit, but the child's heart pumps the oxygenated blood back in circulation.

"This is a new program for Wolfson Children's Hospital," says Mark Hudak, MD, section chief of neonatology and medical director of the ECMO program. "In the past, when we had a newborn or older child who needed ECMO, we transferred the patient to children's hospitals with ECMO programs in Gainesville, Orlando or Tampa. We were sending out about eight to 10 babies a year. The hospital decided it was time to invest its resources to expand the program to offer ECMO to critically ill medical and surgical patients."

ECMO Coordinator Tammy Sleeper, MEd, RPT, NPS, RN, adds, "It allows us to keep and maximally treat our patients with conventional methods, without physicians having to worry about when to have the critically ill patient transported elsewhere for ECMO."

Nick Poulos, MD, surgical director of the ECMO program, says this high-level service was absolutely necessary for Wolfson's pediatric cardiac program, which is expanding rapidly as children from all over the state come to Jacksonville for its services.

"This is considered standard of care in the United States," he states, who completed an ECMO fellowship in Chicago and participated in an ECMO program in Sacramento for 10 years. "Our population is large enough to support an ECMO program. It offers a tool in our armamentarium to save patients who otherwise might die."

Dr. Hudak explains that the Wolfson ECMO program is being used to treat a number of conditions in babies and other children.

"For newborns, typical things we treat include several forms of pneumonia, as well as persistent pulmonary hypertension (PPH)," he says. "PPH is a condition in which there is a high resistance to blood flow in the lungs, leading the blood to bypass the lungs and causing the baby to be blue from low oxygen. That is the most common category for use of ECMO in babies. For older pediatric patients, we use ECMO to treat viral pneumonia, in addition to other conditions, and it has been quite successful."

"ECMO can also be used in patients with status asthmaticus, a medical emergency in which severe asthma does not respond to usual therapy and the patient is at risk for suffocation; in viral endocarditis, a heart infection; meningococcemia, a form of meningitis caused by bacteria which can be deadly in hours," says Dr. Poulos.

Physicians say they are excited to have this life-saving therapy at Wolfson Children's Hospital. "It will be easier on the families, who will not be faced with their child being transported a good distance outside of Jacksonville anymore," states Dr. Hudak. "This is a true benefit to critically ill neonates and pediatric patients throughout Northeast Florida and Southeast Georgia."