Extra Corporeal Membrane Oxygenation
As this is the occasion of the 25th anniversary of the introduction of Extra Corporeal Membrane Oxygenation to the Uk I thought it would be a great idea to introduce it to my readers in some more detail!
Extra Corporeal Membrane Oxygenation is used when a patient has a critical condition that prevents the lungs or heart from working normally. An ECMO machine is very similar to heart and lung machines used during open-heart surgery. It is a supportive measure which uses an artificial lung (the membrane) to oxygenate the blood outside the body (extracorporeal).
The treatment was developed in the USA by Robert H Bartlett MD, with the first successful ECMO treatment for an adult taking place in California in 1971, followed by the first neonatal survivor in 1975.
In 1989, having been inspired and convinced of its merits, ECMO was introduced to the UK by paediatric surgeons, Richard Firmin and Andrzej Sosnowski, both based at Groby Road Hospital (now Glenfield Hospital).
At this time, the value of ECMO was not recognised by the NHS so it was unwilling to fund the new treatment. Mr Firmin approached local charity, Heart Link to consider fundraising for the £200,000 set up cost of this pioneering treatment. Heart Link was convinced of its potential benefits and an appeal was launched.
Since then thousands of babies, children and adults lives have been saved by this technique, including 21-year-old James Mulholland who was only six-weeks-old when he underwent the treatment.
In February 1993, newborn James was suffering with bronchial pneumonia. His consultant, Dr Mike Hocking at Selly Oak hospital in Birmingham had little hope of him surviving, until he read about ECMO treatment at Glenfield.
James was transferred and put on ECMO for six days, until his lungs had recovered enough for him to breathe on his own.
James’ mother, Joanne Mulholland, explained: “To look at him now you would never believe what he went through. He is nearly 6 foot, fit and healthy and loves going to the gym and playing sports. His lungs work perfectly.”
Joanne added, “James would not be here today without ECMO. I will be forever grateful to all the staff at Glenfield who took such good care of him.”
Today, Glenfield remains the UK’s largest and most successful ECMO programme, which was publicly commended for its work during the swine flu epidemic in 2009. It is currently the only UK centre to provide paediatric mobile ECMO, by which the team travel to other centres, stabilise patients on ECMO and then transfer them to appropriate centres for ongoing care. The centre is also one of five in the UK to provide adult mobile ECMO, although Glenfield was the first.