1 in Phoenix:
https://www.azcentral.com/stor...-treatment/2991613001/

2 in Seattle:
https://news.yahoo.com/emergen...r-death-054816082.html

I was thinking last week it would be nice if something like that existed. Obviously it has already been invented and tested. Glad to see docs trying more out-of-the-box stuff.

Sounds a bit complicated and risky, as well as the machines and expertise being few and far between. I wonder if a dialysis machine could be modified to do something similar (oxygenation, pH compensation, etc.)

Edit: Added diagram


Edited: 04/16/2020 at 06:08 PM by RegularJoe

NPR did a story on the doctor that survived due to the machine. He said he was 100% sure that it was the machine that saved his life. Unfortunately, the machines are rare.

I agree, out of the box is good.

-------------------------
I was right.

Edited: 04/15/2020 at 04:01 PM by Cole

Just a clarification here. ECMO is neither experimental nor rare. In fact, your town likely has ECMO capabilities at one of the larger hospitals. Also, ECMO does not save a life. It is known as a bridging treatment. The simple explanation is that it is a way to take blood and bypass the heart and/or the lungs. A machine outside the body (that's the extra-corporeal part) will do the gas exchange and pumping that your lungs and heart do, respectively. For otherwise healthy people with a bad COVID infection, it is not a bad last ditch effort as you can remain on ECMO until your immune system gets the virus under control and your lungs improve. Very cool stuff.

-------------------------

we are they, they are us -- Thich Nhat Hanh

Yeah ECMO has been around a long time. It's typically a last resort.

-------------------------
Capitalism is based on the ridiculous notion that you can enjoy limitless growth in a closed, finite system.

In biology, such behavior of cells is called "cancer".

Another success story on 29-week pregnant Ohio woman

SharkTower, I appreciate the time you've taken to inject doses of reality here. I know a few local ER people, and I wouldn't trade jobs with them in the best of times! Thank you, and best of luck to you in dealing with this pandemic.

My basis for the "few and far between" comment was from the Phoenix article:



Link to FDA 1-page letter

Link to FDA's 13-page PDF

I later saw these:

Article from Ireland:



A BBC article included this about the hospital where Boris Johnson was treated:



Is that (50:1 or 100:1) number realistic, outdated, or more likely in rural/suburban areas? Surprising for an area like Belfast?


Is the ECMO use simpler and less risky if the heart is healthy and only the lungs need to be bypassed?

According to UCSF



Are VV ECMO and VA ECMO typically done with the same machine in different modes, or are they typically distinctly separate machines?

Is there any way a dialysis machine could be modified to do the oxygenation function, in the absence of a real ECMO, and might that buy patients time until a true ECMO machine becomes available?

Dude, really good questions. Excuse my laziness, but I didn't read the articles. But let me give some answers. Not sure where the 50:1 comes from, but ECMO is definitely a very limited resource, enough that many hospitals have to transport patients out for it. Some areas just don't have it at all. Because patients who need it are so sick, sometimes it's just not even feasible to transport them to an ECMO center. And yes, ECMO is much safer and effective in patients who don't have lots of underlying health problems. Picking the right candidate is what makes ECMO so tricky. The 80yr old nursing home patient with every chronic problem currently undergoing CPR is unlikely to benefit. On the other hand, the young healthy woman with a big blood clot in the heart might be a good candidate for ECMO while they fish out the goober in her lungs. Not to go off on a tangent, but the above points to the reality of "healthcare rationing" that is a hot-button term in the media. The truth is that things like ECMO require a specialized team, lots of equipment, big catheters shoved in big blood vessels---all this means risk to the team and the patient, occupying precious equipment and highly trained personnel. It's a super delicate balance that is much more complex than the "picking who lives and who dies" version we hear about in the media. Regarding your question about VA and VV ECMO, the equipment is getting better all the time and it is my understanding that standard setups can do both. It's really just about where you place the catheters. Lastly, another great question about the use of a hemodialysis machine to oxygenate the blood. Coincidentally, a nephrologist mentioned something like this the other day, but I have not heard of anything like that before. It's easy to nerd out on this stuff because it is the latest and greatest in high tech CPR and a relatively new frontier even for people in medicine. EDIT: tried multiple times to make paragraphs but it won't let me. sorry

-------------------------

we are they, they are us -- Thich Nhat Hanh

Edited: 04/17/2020 at 07:31 AM by Sharktower