Walking and Talking on ECMO

For all of us who have been doing ECMO for many years, the concept of walking and talking on ECMO can seem terrifying! But we are being presented with more and more examples of this being done.  Obviously not every patient on ECMO should be walking and talking.  But, there is certainly a subset of ECMO patients for whom these activities make a lot of sense and provide a lot of benefit.  AND can be done safely with proper planning, training, and execution as a health care team.

There are several examples of ECMO patients walking.  CNN recently posted a report of a patient at Children’s Mercy Hospital in Kansas City that’s pretty awesome.  Check it out here 

Kudos to the team at Mercy!  And strong work Zei!

Liquid Fluorocarbon Lavage

A recent report from the group in Pittsburg, PA highlights the use of a liquid fluorocarbon lavage known as PFD (OriGen Biomedical, Inc, Austin, TX, USA) on compassionate use basis. We recently shared another report using the same product from the group in Seattle, WA back in February 2015.

This looks like a promising tool for use with our ECMO patients.  I look forward to Origin obtaining FDA approval for use so that PFD is more readily available.

New Extracorporeal Technologies

There are a lot of projects ongoing in the world of extracorporeal support with new extracorporeal technologies being worked on all the time.  In this post I want to highlight one that is not a life support system, but it could prove to be very beneficial especially to patients who are on extracorporeal life support systems like “ECMO” or “ECLS” as well as “CPB”.

I’ll make some disclaimers before beginning.  1) I have no official or unofficial association with this product nor with the company that created this product.  2) This product is not yet FDA approved. 3) I am not endorsing this product…just simply sharing what I learned about it with our ECMOlogy followers as I find it quite intriguing and see potential for it’s future use in our ECMO patient population.

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CytoSorb® extracorporeal cytokine adsorber to treat critically-ill and cardiac surgery patients.  According to the company’s web site (http://www.cytosorbents.com/tech.htm), this technology is available in 29 countries for patient use now.  And “CytoSorbents received FDA approval of its IDE application to run an initial cardiac surgery safety study in the U.S. in 2015 using CytoSorb® intra-operatively during cardiac surgery.”  The primary use of CytoSorb® as stated on the company’s web site: “CytoSorb® is clinically proven to reduce cytokines in the company’s multi-center, randomized, controlled European Sepsis Trial conducted in Germany. Treatment was safe and well-tolerated in more than 300 human treatments in very sick patients with the worst forms of sepsis and lung injury, and treatment has been safe in nearly 5,000 human treatments overall. Early data suggests that CytoSorb® can reduce organ injury and improve survival in patients at high risk of cytokine injury, particularly those patients with very high cytokine levels, and patients older than age 65.”

As an ECMO Specialist, I immediately think of all of those very sick, septic patients that I have cared for on ECMO over the years.  The helpless feeling of knowing we can oxygenate and pump their blood, yet seeing the damage done and ultimately life lost due to the severe sepsis process that ECMO simply could not do anything for.  How great it would be to have a product like CytoSorb®…

Looking forward to seeing this make it’s way through the FDA process and ultimately being able to use it as another weapon in our fight to make life better for the patients and families we serve.

Written by R Bartilson, ECMO Specialist

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