Using lessons learned from COVID-19 pandemic, Northwestern Medicine launches lung failure training program for community hospitals
When medications and breathing machines aren’t enough, ECMO can serve as a ‘bridge’ to medical improvement or a lung transplant
CHICAGO – When patients suffer life-threatening illness or injuries that prevent their lungs or heart from working properly, extracorporeal membrane oxygenation (ECMO), or extracorporeal life support, is needed. ECMO removes blood from the body, oxygenates it and returns it to the body, acting as artificial lungs. This allows the patient’s lungs to rest and provides more time for medical treatments to address the underlying condition. ECMO is typically performed at larger medical centers that have advanced technology for supporting the heart and lungs.
“When medications and a breathing machine aren’t enough, ECMO can serve as a ‘bridge’ to medical improvement or a lung transplant,” said Kalvin Lung, MD, thoracic surgeon with Northwestern Medicine Canning Thoracic Institute. “We tend to use ECMO for patients suffering severe lung failure from illness and injuries such as COVID-19, the flu, pneumonia, drowning and gunshot wounds. ECMO has fewer complications than intubating, or using a ventilator, to assist the lungs. In large part, we’ve become so much better with using ECMO because of COVID-19 and the flu.”
During the height of the COVID-19 pandemic, with more patients needing ECMO support, the Northwestern Medicine Regional Lung Rescue Program was created to provide community hospitals access to ECMO therapy. Because most patients with acute lung failure are too unstable for transport, the Regional Lung Rescue Program is mobile. The medical team travels to hospitals across Illinois, where they initiate ECMO at the bedside before safely transporting the patient via ambulance equipped with built-in ICU equipment to Northwestern Memorial Hospital in downtown Chicago for further treatment.
“Without ECMO, many of these patients wouldn’t have survived,” said Ankit Bharat, MD, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute. “Since time is of the essence, we’re in constant communication with regional hospital staff to ensure all the necessary medications and resources are mobilized. During times like these, collaboration is vital and their work ahead of time plays a big part in the efficiency of the ECMO procedure.”
“Northwestern Medicine offers a comprehensive and multidisciplinary regional ECMO program. We have found this approach highly successful, and we want to train other physicians, nurses and respiratory therapists so they can offer the same level of care at their own institutions,” said Dr. Lung.
Community hospitals not having access to ECMO is a nationwide problem.
On Wednesday, Feb. 15, Dr. Lung and his colleagues hosted a hands-on, interactive ECMO training course inside the new simulation and education center at Northwestern Medicine Lake Forest Hospital. The center includes numerous point of care spaces, including an ambulance and full-size operating room, where two ECMO scenarios will play out with simulation manikins. Participants include Northwestern Medicine thoracic surgeons, critical care physicians, ECMO specialists, respiratory therapists, nurses and local paramedics.
“Community hospitals not having access to ECMO is a nationwide problem,” said Randy Orr, MD, pulmonary and critical care specialist at Northwestern Medicine Lake Forest Hospital. “ECMO simulation isn’t widely used, and this is a wonderful opportunity to not only educate the medical community about ECMO and the Northwestern Medicine Regional Lung Rescue Program, but to promote the opening of the simulation and education center at Lake Forest Hospital and its benefits to clinical education.”
“Our goal is to offer this ECMO training course to hospitals across Illinois and eventually have it be replicated in other states. Whether you’re receiving care at an academic medical center or a community hospital, we want ECMO to be a universally available tool for treating severe lung failure,” said Dr. Lung.