ECMO, a life-saving procedure, celebrates 20 years at YNHCH

ECMO support may take from a few days to several weeks, depending on the patient and illness. Elizabeth Crespo, ECMO-certified RN on the NNICU, provides a constant watch for bleeding, ECMO circuit-related problems, and changes in the baby's condition.
ECMO support may take from a few days to several weeks, depending on the patient and illness. Elizabeth Crespo, ECMO-certified RN on the NNICU, provides a constant watch for bleeding, ECMO circuit-related problems, and changes in the baby's condition.

In 1992, Yale-New Haven Hospital made history when it became the first hospital in Connecticut to introduce an innovative therapy for the treatment of extreme neonatal respiratory failure.

Called extracorporeal membrane oxygenation (ECMO), this life-saving technique mimics the natural function of the heart and lungs, providing time — temporarily — for an infant's or child's organs to recover.

ECMO provides the patient with enough oxygen to survive and is often a last resort when all other respiratory therapies have been exhausted. Unlike a heart-lung machine, which is utilized for only a few hours during surgery on the heart and/ or lungs, ECMO can support life for several days to weeks.

Most patients who receive ECMO would die if it were not used. Through the leadership of Yale-New Haven's Pediatric Surgery and Perinatal Medicine departments, in its 20 years, the ECMO program has supported nearly 100 children of all ages.

ECMO-trained, board-certified attending neonatologists, neonatal nurse practitioners, physician assistants and neonatal intensive care registered nurses care for Neonatal ECMO patients in the Neonatal Intensive Care Unit (NNICU). In the PICU, a separate team of ECMO-trained, board-certified pediatric critical care attendings, nurse practitioners and pediatric critical care registered nurses care for pediatric ECMO patients. The ECMO team also includes respiratory therapists and board-certified pediatric cardiologists, pediatric surgeons and pediatric cardiovascular surgeons.

ECMO technology is extremely complex and significantly different from conventional critical care equipment. Staff must be highly trained to use ECMO safely and effectively. In addition, the frequency of ECMO cases at YNHCH is unpredictable and can vary significantly from year to year. In 2010, YNHCH initiated an on-campus ECMO simulation program so staff can remain prepared.

YNHCH's ECMO program is nationally recognized for excellence and has earned its second consecutive Award for Excellence in Life Support from the Extracorporeal Life Support Organization. The award recognizes those centers that demonstrate an exceptional commitment to evidence-based practices and quality measures, staff training and continuing education and patient satisfaction.

"Yale-New Haven Children's Hospital is recognized for its excellence, dedication and innovation in the care of newborns and children," said Matthew Bizzarro, MD, director of the program. "Our ECMO program is one example of how exceptional, well-trained staff is ready on a moment's notice to help the sickest and most vulnerable patients recover."