WASHINGTON — A technology originally developed for premature babies might be helping to save some of the sickest swine-flu patients by rerouting their blood so their lungs can rest.
It is a risky approach using equipment that only certain specialized hospitals have. But faced with children and young adults struggling to breathe despite ventilators has intensive- care doctors dusting off the ECMO machines that they often consider last-ditch and almost never use for influenza.
“It was pretty scary knowing that was his blood flowing through those tubes in and out of his body,” said Susie Damm of Omaha, whose 19-year-old son Ryan survived a life-threatening bout after 10 days on ECMO, which stands for extracorporeal membrane oxygenation.
No one knows which patients are most likely to benefit — not everyone does. But ECMO is gaining attention after Australian researchers reported that the machines helped during that country’s outbreak of what scientists call the 2009 H1N1 flu strain.
A voluntary U.S.-based registry counts 107 critically ill swine-flu patients recently treated with ECMO, most from this country.
In Omaha, Dr. Jeff DeMare credits the technique with saving Ryan Damm and 7-year-old Tania Romero-Oropeza after both patients’ lungs went from clogged to nearly useless in a stunning matter of hours.
“You wonder, ‘OK, we’ve got a lot of folks who get this disease, and why is it so bad in some cases?’ We don’t have a real good handle on that,” said DeMare, a critical-care specialist at Children’s Hospital & Medical Center.
Whatever the reason, “your body needs time to fight the infection,” he said, and he gambled that the pricey equipment could buy that time.
ECMO is decades-old technology that essentially offers a temporary lung bypass. Tubes carry blood out of the body so a filter can remove carbon dioxide and reinfuse oxygen, and then dump the blood back. Patients can stay on the machine for weeks.
There are many cautions. It’s risky, requiring blood thinners to avoid clots and posing the potential for additional infection. It can double the cost of ICU care. Only about 120 hospitals in the U.S. offer it, most just a few times a year for newborns with respiratory failure, its primary use.
