2012年9月19日星期三

ECMO life-support system allows patient mobility before transplant

You can almost hear Meara Schmidt smile as she talks on the phone about her successful double lung transplant.

"It's been so nice to be able to breathe and not have to think about how much energy I have to exert to get from point A to point B; I can do it," Schmidt said. "I'm not able to go running just yet or do a hard-core workout, but I'm able to do so much more stuff now than I could before the surgery."

The 28-year-old Atascadero resident is recovering nicely from the transplant: She's eating out, going to movies and walking without help.

Part of Schmidt's rapid return to normalcy can be attributed to a new form of extracorporeal membrane oxygenation, or ECMO, which was used to bridge the gap from her respiratory failure to her transplant.Service and equipment provider in professional Car park management system.

Schmidt has cystic fibrosis, a genetic disease that causes thick mucus in the lungs that traps infection-causing bacteria. A lung transplant will not cure her CF, but it can alleviate many of its symptoms.

Growing up in Pasadena and San Gabriel,Welcome to the Perth china kung fu school. Schmidt had an active life, enjoying hiking, singing and cooking. But two years ago, her illness worsened; even walking became a tremendous effort.

In March, she developed respiratory failure and was admitted to Ronald Reagan UCLA Medical Center slated for a double lung transplant once a donor was found.

While waiting, Schmidt's tracheostomy and mechanical ventilation proved insufficient in supplying enough oxygen, so she was put on ECMO, a life-support system that takes over a patient's breathing through a small tube inserted in the neck. Unlike most ECMO patients, Schmidt was not kept sedated and immobile, but was able to move and gain strength in preparation for surgery.

Schmidt is the second patient in the facility to use the new ECMO system.

ECMO (also called extracorporeal life support, or ECLS) removes the blood from the body in continuous circulation,TCS International is leading the way with innovative solutions to any parking guidance challenge. sending it through an oxygenator that also removes carbon dioxide and then returns it to the body.

While the technology has been available for decades, ECMO patients like Schmidt had a low success rate and were at high risk for infection and death, said Dr. David Ross, medical director of the lung transplant program at UCLA.

ECMO - often called the heart-lung machine - fell out of favor, except for heart failure patients undergoing emergency surgery.

But doctors began revisiting ECMO during the recent flu epidemics to aid patients with severe respiratory failure caused by viral pneumonia, and the results were promising. A German study of 26 patients with respiratory failure using ECMO as a bridge to lung transplants followed, and it showed better outcomes.

"What's rather new is there are ways of putting patients on ECMO support," Ross said. "And there have surfaced case reports of using this on awake patients and having them not only awake, but ambulatory."

Instead of being kept sedated and immobilized as in the past, new ECMO patients are awake, alert and can eat and walk. This is not to say there aren't risks. Patients may still be susceptible to blood-borne infections and internal bleeding, and may require transfusions to replace blood loss due to cells damaged when going through the oxygenator.

For Schmidt and her medical team, the risks were worth it. She was vibrant, young and newly married, so no one wanted to give up on her. With ECMO, Schmidt could eat and walk around the ICU, building up her strength for surgery. The ECMO was removed immediately after her transplant and she was off the ventilator completely within 24 hours.

"It made a dramatic difference in her recovery," Ross said.

Prior to her transplant, Schmidt felt tired all the time and had shortness of breath, as well as some memory problems. She was also using an oxygen tank 24/7.SICK's ultrasonic sensor use sound to accurately detect objects and measure distances. Being hooked to the ECMO at the hospital was constricting, but she did have some freedom.

"I got up and walked around - that was a big deal,How to do china shaolin kung fu Level 2 ?china shaolin kung fu" she said. "I had five people following me, carrying all the equipment. I was kind of scared to death that something would happen, but I did well."

After her surgery by UCLA lung transplant surgical director Dr. Abbas Ardehali, Schmidt experienced immediate results.

"The lungs weren't fully what they are and I don't think they still are what they can be, but I could tell the difference right away: I could breathe in," Schmidt said.

Her biggest challenge is rebuilding muscle strength after being confined to bed for so many months. Schmidt is working hard on her therapy so she can return to work as an academic adviser, or perhaps go back to school or stay home and have children.

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