Medical Rounds with Dr. Jason Gluck

Imagine a device that can take over the heart and lungs when these primary organs begin to shut down. It’s called ECMO. Dr. Gluck was instrumental in bringing this advanced technology to Hartford Hospital and it’s helping to save lives.



Q. WHAT DOES ECMO STAND FOR AND HOW DOES IT WORK?
A. ECMO is short for extra corporeal membrane oxygenation. In the past, if someone had a heart or lung failure that was immediately life threatening yet potentially reversible…they died. Medical teams didn’t have enough time to work with them. With ECMO technology, we are able to prolong that process and give them temporary heart and/or lung support to give the medical team enough time to intervene and make that difference. Essentially, blood is pumped from the patient to a pump, where it is conditioned by adding the nutrient oxygen and removing the toxin CO2. This treated blood then returns the back to the patient, allowing the heart and/or lungs to rest and relax.

Q. EXPLAIN THE PROCESS OF WHAT HAPPENS WHEN A PATIENT IS ON ECMO AND HOW YOU RESTORE FUNCTION IN THE HEART AND LUNGS?
A: A patient can be placed on ECMO either at Hartford Hospital or a requesting institution if needed. Essentially, once the need for ECMO is confirmed, cannula’s or large tubes are placed into the patient. Once is for blood to flow from the patient to the ECMO circuit, this blood is low on oxygen and high on CO2. A second tube is placed for the blood to be returned to the patient, this blood is rich in oxygen and low on CO2. At the bedside, one can see these large tubes running from the patient to the pump and back. With this running, the multidisciplinary team adjusts medical therapy and customizes a treatment plan for the individual patient. Once a patient is deemed appropriate for explant, the ECMO circuit and tubes are removed, and, hopefully, the patient recovers. In appropriately selected patients, the chance for survival goes from < 10% without ECMO to 55-65% with ECMO.

Q. HOW LONG CAN A PATIENT BE ON ECMO?
A. Patients can be supported by this technology from hours to weeks. The average time spent on ECMO support at Hartford Hospital is about 7 days. During that time a specialized multidisciplinary team attends to the patient daily in the intensive care unit.

Q. ASIDE FROM CARDIAC ISSUES, WHAT OTHER TYPES OF CONDITIONS CAN ECMO BE USED?
A: If a patient has life-threatening acute respiratory failure ECMO may be used as salvage therapy to rescue the patient. Some examples are a serious case of the flu, pulmonary embolus (blood clot in the lung), adult respiratory distress syndrome or ARDS, severe reversible hypercarbic respiratory failure (levels of carbon dioxide in the blood that are too high) or patients with chronic lung disease who are already listed for lung transplantation as a bridge to transplant. It can also be used in cases of severe, acute life threatening danger where the diagnosis is not yet clear, such as with the very rare but significant case of a young mother who crashes during delivery.


For more information

Call: 860.972.1212
Visit: https://hartfordhospital.org/services/cardiology-heart-care/conditions-treatments/extracorporeal-membrane-oxygenation


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