Please forgive our light hearted title this week, but we have a story that has such heart-warming results that we could not resist begining with a little levity. Of course this blog article involves much more serious medicine than the old cliché of “Take two aspirin, and call me in the morning.” This is the story of an amazing piece of modern medical equipment, called the ECLS system, which is short for Extra Corporeal Lung Support, and the equally amazing power of human lungs to heal.
What is ECLS?
In the beginning, the prime mission for ECLS was to act as a “Bridge,” to lung transplantation. The ECLS system was designed to “oxygenate the patient’s blood outside the body, which gives lungs the chance to rest and heal.” Do not confuse this with a ventilator.
When a patient is in lung failure due to flu or pnuemonia, many experts agree that “the ventilators routinely used in this setting can actually add further injury to the lung on top of the original injury caused by the flu or pneumonia.”
Think of the ECLS as a completely artificial substitute for your lungs. If its name sounds a little familiar, yes we blogged about a similar machine called the ECMO last year. Likewise it is related to the heart-lung machine, which has been in use in operating rooms for three decades. It is not used to assist breathing, like the ventilator. Instead of taxing injured lungs to breathe, it adds oxygen directly to the blood in a completely different way:
1. A tube is inserted into a large vein for removal of blood.
2. Oxygen is added to that blood, and carbon dioxide is removed.
3. The blood is pumped back into the patient via a different large blood vessel.
Avoiding the ventilator also means that the patient avoids the possible injuries or infections, which often cause complications in ventilated patients. It must also be stated that the use of the ECLS system requires great expertise in order to avoid an entirely different set problems such as “clots, bleeding problems and infections related to use of the device.”
Among ECLS experts are Dr. Shaf Keshavjee and Dr Eddy Fann. Dr. Keshavjee directs the ECLS Program as part of the Toronto Lung Transplant Program at Toronto General Hospital . He is a thoracic surgeon and the Surgeon in Chief at University Health Network. Dr. Eddy Fan, is an Intensivist and Medical Director of the same institution They began to suspect that ECLS could be more that a bridge to transplantation due to a certain case earlier in the year.
Once on the ECLS, the patient’s lungs were so relieved with rest that they were able to heal. The transplant procedure was cancelled! The ECLS had proven it could be more that a bridge to transplant surgery.
And so it came to pass, in the story of ECLS that five critically ill flu patients, in lung failure, have been saved with the use of the artificial lungs—and, of course, no transplant. Using ECLS on the five patients gave their lungs the chance to rest and recover without the invasive risk of the ventilator.
Dr. Fann said, “As the technology has improved over the years, we are now able to offer this life-saving therapy to the small percentage of patients with influenza that get into severe trouble with acute lung injury.”
Here in Orlando, the Florida Lung Doctors applaud innovative and quick thinking team of thoracic surgeons, intensivists, perfusionists and specially trained nurses in the Intensive Care Unit at Toronto General Hospital.
They derived a new use for the ECLS technology. Dr. Keshavjee said, “ This is part of our strategy to be prepared should we have a serious flu epidemic.”
They have proven that superior technology is only as good as the superior thinkers and doers who use it with superior initiative and courage.
We hope you enjoyed today’s heart-warming success story, and we hope you will make visits to our blog a regular part of your New Year 2013 resolution routine. We resolve to bring you the latest news in research lung and respiratory patient care. Please feel free to click a button “share” us with your face book friends!