Before her son was even born, Rosemary Ellinger was told her baby wouldn’t survive without the support of a medical machine.
Ellinger’s son, Mason, was prenatally diagnosed at the University Hospital with congenital diaphragmatic hernia — a malformation of the diaphragm due to a birth defect. Because of this severe condition, there was a 99-percent chance he would need extracorporeal membrane oxygenation, or ECMO, to live.
The machine is composed of a pump, an oxygenator and tubing, which pump blood from the body, remove carbon dioxide from the blood and add oxygen to the blood before pumping it back in. Rosemary said it became the only option, but it ultimately saved her son’s life.
Mason, now 3 years old, is one of more than 2,000 patients the University of Michigan Health System’s Extracorporeal Life Support Program has treated.
Robert Bartlett, director of the University Hospital’s ECLS Program, contributed to the development of current ECMO machines used to treat patients with conditions like Mason’s.
Based on a modified 1953 invention of the heart-lung machine, ECMO is used to support patients — primarily infants — with failing hearts or lungs, according to Jonathan Haft, a cardiac surgeon at the University Hospital.
With about 80 to 100 ECMO patients a year, the University Hospital currently maintains “one of the busiest programs in the country” and treats adults, children and infants, Haft said. In January, the hospital’s ECLS Program treated its 2,000th ECMO patient, an infant named Victor, he said.
Haft said he’s proud the program has grown to become what he said is the largest ECMO treatment program in the world. Because of Bartlett’s involvement with the machine’s creation, the University has always been a leader in the field, Haft said.
Bartlett, a professor emeritus of surgery at the University Hospital, began experiments to extend the use of the heart-lung machine in the late 1960s. He built several extracorporeal devices in 1968 and 1969 at Boston Children’s Hospital and Harvard Medical School.
Bartlett later took his research to the School of Medicine at the University of California, Irvine, where he worked with other doctors to use the ECMO machine on clinical patients. He then brought the program to the University Hospital in 1980.
As ECMO became the standard treatment for infants with certain diagnoses, Bartlett said hospitals around the world began developing their own ECMO programs, and representatives coming to the University Hospital during the 1980s and 1990s for information and training seminars. Now almost every hospital associated with a university has an ECMO program, but medical professionals still reach out to UMHS for assistance, Bartlett said.
“Michigan has been sort of the fountainhead of this information for all of its development,” Bartlett said. “We have calls basically every week from hospitals around the world.”
These calls sometimes require UMHS doctors to fly to other hospitals to place patients on ECMO on location or to bring them back to Ann Arbor for treatment, Haft said.
Ann Arbor also houses the Extracorporeal Life Support Organization, an international society affiliated with the University that maintains a registry of ECMO patients around the world. Members of the organization can submit data to the registry and use it as a resource to look up patient outcomes for quality assurance and research purposes.
Though ECMO is most commonly used for infants, Haft said UMHS also received frequent inquiries from other hospitals during the H1N1 virus epidemic. During the outbreak, people sought means to develop ECMO programs for adults who were suffering from respiratory failure.
Mason experienced a different ECMO course than most due to his birth defect, which required him to receive treatment directly through the heart instead of through a vein. Ellinger said he was able to successfully come off of ECMO after 18 days. She added that while her son was on ECMO, she was comforted by the level of expertise the nurses and technicians at the University Hospital exhibited.
Now in preschool, Mason doesn’t have any ECMO-related side effects and is only affected by symptoms of his congenital birth defect, Ellinger said.
“If you look at him now, you wouldn’t be able to tell,” she said.