ECMO, which stands for Extracorporeal Membrane Oxygenation, is an advanced technology that functions as a replacement for a critically ill child's heart and lungs. It’s used to support a child who is awaiting surgery, or to give a child's vital organs time to recover from heart surgery or disease.
Boston Children's Hospital is home to one of the largest pediatric ECMO programs in the world; we provide services to critically ill children in the New England region, and to those who are referred from other states and internationally.
We serve between 50 and 60 patients with severe respiratory or cardiac problems each year. Since its establishment in 1984, the ECMO Program has supported more than 900 children.
Throughout the 20-year history of the ECMO Program at Boston Children's, we have gained considerable expertise, minimized complications and increased its success rate for survival to 60 percent, higher than the national average of around 40 percent.
The ECMO Program is housed within the hospital's Medical-Surgical Intensive Care Unit. Here, a multi-disciplinary team of cardiac intensive care unit physicians, nurses and specially trained respiratory therapists provide customized ECMO care for each child they treat. Specialists in pediatric infectious diseases, pulmonary disease and pediatric neurology also are readily available to help manage and monitor cardiac ECMO patients—and communicate with families.
A mother's story
Our daughter, Lauren Rose Walsh was born at South Shore Hospital on February 12, 2004. She was considered at preemie at 34 week but was relatively healthy at birth.
We all laughed in the delivery room as this 6lb, 4oz baby who demonstrated how strong her lungs were and how seemingly healthy and strong she was.
Shortly after delivery, the medical staff noticed that she was having some difficulty with her “transitional breathing” and, because this was not uncommon for premature babies, they decided to treat her in the NICU with oxygen and for observation. Over the next few hours her condition increasingly worsened as they tried to determine what was wrong with her while administering antibiotics for a presumable Respiratory infection.
Because her condition continued to deteriorate, despite all that they were doing, the Neonatologist at South Shore Hospital recommended that Lauren be transported to Boston Children’s Hospital where she would need to be placed on a high-frequency Oscillating ventilator, which they believed would improve her respiratory condition. It would not be determined until much later that I, her mother, Susan, had tested positive for Group B Strep, and that Lauren’s blood had become Septic because of this infection.
Approximately 7 hours after our joy, elation and laughter in the delivery room, the Boston Children’s Hospital Critical Care Transport Team arrived to take Lauren to the Hospital. She had to be heavily sedated and medically paralyzed so that she would not move during the transport. One of the last things we will always remember was the Neonatologist at South Shore Hospital saying to us “Your baby is very sick and we are doing everything that we can do to save her.”
My husband Greg was advised to stay behind with me while the Transport Team took Lauren to Boston Children’s Hospital and got her settled. The staff at South Shore Hospital made arrangements to transport me to Brigham and Woman’s Hospital so that I could be closer to Lauren. Meanwhile, at Boston Children’s, while they were trying to stabilize Lauren, her heart began to fail. She went into cardiac arrest and had to be resuscitated twice, once for a full 13 minutes before they were able to get her heart beating again. After being stabilized again, she was then placed on an Extra-corporeal membrane oxygenation (ECMO), which is a special procedure that uses an artificial heart-lung machine to take over the work of the lungs, and heart as in Lauren’s case. In newborns ECMO is used to support or replace an infant's undeveloped or failing lungs and heart by providing oxygen and removing carbon dioxide waste products so the lungs and heart can rest while being treated for her infection.
The next 24-48 hours in the ICU were filled with tears and lots of prayers as we waited and worried tremendously. We have never been so scared and terrified in our lives!
Greg and I were advised to contact our families and recommend that they come to the Hospital immediately. We were never really told what her chances of survival really were because the doctor’s just didn’t know. They just kept saying her condition was “hour to hour” and that “every hour that she is alive was a good sign.”
Around Day 4 of her short life she started to stabilize and slowly improve. She was finally taken off EMCO after one week and transferred back to the NICU, where she spent another two weeks in Boston Children’s NICU while gradually being weaned off her ventilator, feeding tube and medications. Lauren was then transferred back to South Shore Hospital’s NICU, where she spent an additional two weeks while transitioning enough to gain weight and strength to come home. Lauren finally came home to us on March 18, 2004, after being hospitalized for five weeks.
Lauren still has a long way to go but she has made such miraculous progress since her first week of life. She still has a lot of healing to do and there is no way of knowing the long-term effects that the trauma she experienced so early in her life will have on her.
As for today, Lauren is a very active and healthy 3rd Grader! We are extremely lucky to have been blessed with such a beautiful, vibrant and healthy baby girl. Her smile will warm your soul! We will always be grateful to the entire Staff and Personnel at Boston Children’s Hospital for the opportunity to see that smile everyday.
Just how can you say “Thank You” to the people that saved your child’s life?
— Susan Walsh