Air Force medical staff celebrates advances in ECMO Published Oct. 12, 2010 By Staff Sgt. Robert Barnett 59th Medical Wing Public Affairs LACKLAND AIR FORCE BASE, Texas -- This year marks the 25th anniversary of the 59th Medical wing staff conducting Extra-Corporeal Membrane Oxygenation missions. ECMO is a machine that provides cardiac and respiratory support primarily to eligible infants and children whose heart and lungs are so severely diseased or damaged that they can no longer serve their function. Wilford Hall Medical Center provides the only long distance ECMO transport option in the world. The ECMO mission here is also the only one in the Department of Defense and is the first ECMO center in Texas. There have been 187 patients treated to date, with 76 requiring transport on ECMO. The number of requests for transport on ECMO has increased in the past five years, with an average transport distance of over 1,000 miles. While ECMO is primarily focused on infants and children, a new venture to provide ECMO for adult trauma patients is underway. "We performed a review of the Joint Theater Trauma Registry for all the combat casualties and found that there were a number of patients that had very severe lung injuries that might have benefited from ECMO," said Lt. Col. (Dr.) Jeremy Cannon, medical co-director of the surgical intensive care unit at Brooke Army Medical Center. "We're using that as motivation to expand our existing capability to now be able to take care of adult patients with the same technology." "My primary goal is to expand the capabilities of the current neonatal/pediatric ECMO program so that we can offer ECMO to combat casualties who are failing ventilator support," added Dr. Cannon, who served at WHMC four years prior to his current position "ECMO was initially done 30 years ago in adults but it was not very successful; today we have better knowledge, improved skills and technology," according to Lt. Col. (Dr.) Susan Doltzer, ECMO director. According to Heather Campbell, ECMO coordinator, the intent is to eventually offer adult ECMO services at BAMC for trauma patients who may benefit. "We also will be training some of the adult trauma physicians and staff in ECMO for a new research protocol they will be implementing at BAMC," said Ms. Campbell. The first adult patient ever put on an ECMO circuit at Wilford Hall was Airman Paige Villers. Airman Villers caught the adenovirus, locally known as "boot camp flu." Airman Villers had a rare strain more common to Russia and Eastern Europe. It took time and ultimately a team of over 125 staff, but approximately three months later Airman Villers recovered enough to attend the Basic Training graduation ceremony in a wheelchair and was presented her Airman's coin and became the youngest Airman to receive an Air Force Achievement Medal. ECMO has come a long way over the years, according to Cheryl Collicott, senior ECMO coordinator. "I entered ECMO on active duty in 1985 and was on the first ECMO transport here," Ms. Collicott said. "I was active duty 15 years and then became a civilian employee. Because I already had the knowledge and skills, and because I was willing, I was the first civilian on an ECMO transport at WHMC." There are more civilians on transports now, she said. "It was cool to see the transformation of ECMO over the years from the very simplistic first generation little green litter strapped to a rubber-made cart, to our third generation version with all the advanced equipment." The first ECMO class to train on caring for adult casualties will be held October 5-7 at WHMC. Dr. Michael Hines, a nationally-recognized speaker and specialist in thoracic surgery, will provide several of the lectures. Dr. Hines is a graduate of Wake Forest University School of Medicine. He has additional knowledge and experience including congenital heart defects, thoracoscopy and video-assisted thoracic surgery. Although the course is only open to neo-natal intensive care, pediatric intensive care and adult intensive care staff in the ECMO program, there will be limited extra seating available for the lectures. For more information on the ECMO class, contact Heather Campbell at 210-292-2415. USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez) Photo Details / Download Hi-Res USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez)