Wednesday, March 13, 2013

How heart-lung-assist system helps desperately ill patients recover

Michelle Rivera (left) poses with her husband, Roger, and her sons Donovan, Gregory and Ryan. They also have a daughter, Rachel.

A viral infection was causing life-threatening heart failure in Michelle Rivera, a patient at Loyola University Medical Center in Maywood, Ill.

Because Rivera’s weakened heart was pumping so little blood, her lungs were filling with fluid and her liver, kidneys and other organs were shutting down.

But a new state-of-the art life support system called Cardiohelp® saved Rivera’s life. The system bought enough time for her heart to recover: It assisted the heart by pumping blood to an oxygenator (artificial lung), which added oxygen to the blood and removed carbon dioxide.

During the five days Rivera was on the machine, her heart and lungs were able to rest and recover from the infection, called viral myocarditis. Without the support, Rivera almost certainly would have died, said Loyola heart failure specialist Alain Heroux, MD. “It was her only option,” Dr. Heroux said. “Medication was not enough."

Rivera, 42, of Norridge, Ill., is expected to make a full recovery. She feels she was very unlucky to get the infection but extremely fortunate to receive the life-saving treatment. “It’s like finding a four-leaf clover after being struck by lightning,” she said.

The system is known as extracorporeal life support (ECLS) or extracorporeal membrane oxygenation (ECMO). Loyola has used the system on more than a dozen seriously ill patients so far, said chief perfusionist David Kouri.

Cardiothoracic surgeon Jeffrey Schwartz, MD, said the system is a last-line therapy to sustain life. “We have had some pretty remarkable outcomes,” he said.

For example, Andrew Berryman, 19, was transferred to Loyola after suffering a severe allergic reaction to anesthesia during a tonsillectomy at another hospital. At one point it appeared Berryman would need a heart transplant – if he even survived. But after he was put on the machine, his heart made a remarkable recovery. The Elmhurst, Ill., resident and college sophomore has made a nearly complete recovery from his strokes. He was among the patients honored at Loyola’s recent Rehab Patient of the Year Celebration.

Dr. Heroux said the system involves a multidisciplinary team including cardiologists, surgeons, critical care physicians, electrophysiologists, anesthesiologists, perfusionists and nurses.

Kouri said the system can be used to buy time to recover in scenarios such as these:

  • A patient is unable to come off a heart-lung machine following surgery
  • A patient is waiting for a lung transplant
  • A patient has experienced cardiogenic shock from a viral infection, heart attack, etc.
  • A patient is suffering lung failure due to a severe case of the flu

About Loyola University Health System

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system that includes Loyola University Medical Center (LUMC), located on a 61-acre campus in Maywood, Gottlieb Memorial Hospital (GMH), on a 36-acre campus in Melrose Park, and convenient locations offering primary and specialty care services throughout Cook, Will and DuPage counties. At the heart of LUMC is a 547-licensed-bed hospital that houses the Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, a burn center, a children's hospital, Loyola Outpatient Center, and Loyola Oral Health Center. The campus also is home to Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. The GMH campus includes a 254-licensed-bed community hospital, a Professional Office Building with 150 private practice clinics, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. It serves people and communities in 22 states from coast to coast with 93 hospitals, and 120 continuing care locations — including home care, hospice, PACE and senior living facilities — that provide nearly 2.5 million visits annually.