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The "Last Resort" Lifesaving Technique That Gives Hope to the Sickest Heart and Lung Patients in Oklahoma

09 December 2015

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Holly Wright, RN, who is a transplant nurse manager in the Advanced Cardiac Care program at INTEGRIS, puts it clearly: when the sickest of the sick are in acute heart or lung failure, and death is imminent, treating them with ECMO (extracorporeal membrane oxygenation) therapy is their last hope. “Quite simply, the ECMO treatment can often mean their last chance at life,” she says.

ECMO is at the forefront of mechanical support technology. It consists of a special external machine that pumps blood from the patient, oxygenates it, then pumps it back in. Essentially, the machine acts as the body’s heart and lungs and provides total support to allow those vital organs to rest and recover. The machine does all the work until the heart and lungs can heal themselves to once again begin working on their own.

The ECMO technology is not new. Traditionally, it has been used to support underdeveloped hearts and lungs in preemies. However, medical advancements have increasingly inspired some physicians to use the therapy in support of the most critically ill adults.

In the fall of 2014, INTEGRIS recruited Aly El Banayosy, M.D., and Michael Koerner, M.D., both world renowned cardiovascular critical care and ECMO specialists, from Pennsylvania to Oklahoma to launch the state’s first and only ECMO program for adults. Banayosy believes the therapy will ultimately change the way hospitals care for patients near death from catastrophic heart and lung events.

“The old ECMO technology didn’t allow us to run ECMO long enough to give a patient time to recover. It was used for two days previously; now, we can use it up to six weeks for advanced management and follow-up, which in many cases is enough time for the heart and lungs to recover,” says Banayosy. In the year since the program’s inception at INTEGRIS, the ECMO therapy has been used on desperately sick people suffering from the flu, pneumonia, chest trauma, heart attacks, heart transplants and more, primarily in the Oklahoma City metro area.

Banayosy and his team dreamed of being able to offer this lifesaving therapy across the state and the surrounding region, too. However, the ECMO machine’s substantial bulk, as well as the expert clinical rescue team required to use the machine and implement the therapy, made this dream seem impossible. As Karl Nelson, RN, M.B.A., administrative director of the INTEGRIS Advanced Cardiac Care program puts it, “it’s not like we could just hop in our Toyota, throw the ECMO machine in the back, and go save these people.”

But thanks to funding from INTEGRIS Foundation donors, Banayosy’s dream is now a reality. The donor contributions facilitated the purchase of a transport vehicle and furnished it with the newest generation of portable ECMO technology, equipping it as a fully mobile rescue vehicle. Now the INTEGRIS team can travel with their tech and equipment to the very sickest in Oklahoma, in even the most rural settings. “The dying in Woodward, the dying in Ardmore, the dying in Lawton … they have a chance now,” says Nelson.

In addition, INTEGRIS Foundation donors funded the purchase of five more ECMO machines for INTEGRIS hospitals across the state, ensuring communities in and close to south Oklahoma City, Edmond, Yukon, Miami and Enid have access to this “last resort” lifesaving technique.

Although INTEGRIS is the only health care system in Oklahoma that offers this comprehensive adult ECMO program with this high level of acute care, Banayosy and the ECMO team are committed to building a network so that all physicians and hospitals in the region know this advanced therapy is now accessible to their critically ill patients, regardless of the hospital’s affiliation. “We now can travel to any other hospital with the tech and equipment to work with other critical care doctors throughout the region,” says Nelson. To aid in that effort, INTEGRIS has a 24 hour ECMO hotline, with ECMO physicians available 24/7 for consultation with other hospitals and doctors throughout the state.

The transport vehicle and the ECMO machines will buy more time for some of the sickest people throughout Oklahoma, in some of the most remote locations. The ECMO therapy they can now access will extend their lives and give them a fighting chance for tomorrow.

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