ECMO Saves the Life of a Young Mother
Technology, teamwork and community generosity pull off this medical miracle.
To a chorus of cheers from staff, D’Andrea Penn left The Moses H. Cone Memorial Hospital straight into the arms of her young daughter. “I didn’t even know she was going to be there,” Penn says. “That was a great surprise for me.”
For Penn, it marked the end of a harrowing two-month hospital stay.
An ambulance brought Penn to the hospital after a car wreck in the wee hours of July 3. She was thrown from the car and came into the hospital with internal injuries, broken arms and even broken bones in her face. But it was her lungs that worried Dr. Burke Thompson, the trauma surgeon.
“We were really struggling,” Thompson says. “She had a lot of blood coming out of her lungs, and we couldn't get her oxygenated no matter what we did. The only thing I could think of was trying ECMO.” It turned out to be a fateful decision.
ECMO to the Rescue
ECMO, or extracorporeal membrane oxygenation, is an advanced form of life support.
Drs. Zane Atkins and Daniel Bensimhon with ECMO
It involves a mini heart-and-lung machine that does what the lungs normally do, it removes carbon dioxide and replaces it with oxygen. This allows the lungs to rest and recover. But it can be tough on the body and is a last resort for severe cases of trauma and Acute Respiratory Distress Syndrome (ARDS), which includes complications from COVID-19.
“I knew that Dr. Van Trigt was on call,” Thompson continues. “I called him, and we discussed a couple other things to try. We got her to the ICU, and we were not getting anywhere.”
Dr. Peter Van Trigt, a cardiovascular surgeon, recalls the conversation. “He called me from the operating room when they were dealing with life-threatening bleeding, and we talked about using ECMO. She’d been on a ventilator to support her lungs on the highest possible settings with the highest possible concentration of oxygen, but she was still having problems,” Van Trigt recalls.
The ECMO team decided technology was the only way to save Penn.
Penn’s young age made her a good candidate. Just setting up ECMO is a delicate process requiring tubes called cannulas to be carefully inserted. It is even more challenging in cases of severe trauma like this one. Van Trigt and his team cannulated Penn and her blood oxygen level instantly got better.
The team, which involved about 20 people, put Penn on veno-venous ECMO, which primarily supports the lungs. VV ECMO oxygenated and removed the carbon dioxide from her blood. The team also performs this procedure with COVID-19 patients or, historically, with flu patients or anyone in severe ARDS.
After a couple of weeks, Penn’s bleeding was under control. During this time, trauma surgeons did additional work on her stomach and liver to stop bleeding there.
Only about 10% of hospitals in the United States have ECMO. Moses Cone Hospital is one of them, thanks to the foresight of invasive cardiologist Dr. Daniel Bensimhon, several colleagues and a group of community donors who raised more than $225,000 to support Cone Health's investment in the ECMO program.
“Fortunately, the physicians knew enough about our program to call and say, ‘Hey, you know we would like to get this patient onto ECMO. Is that an option?’ and within two hours, she was in the operating room getting ECMO,” Dr. Bensimhon says.
He is quick to praise the ECMO team of doctors, nurses, techs and perfusionists. “You have to have a surgeon and a team that's willing to say, ‘Let's go right now.’ Get organized right now. There is just a tremendous amount of coordination here between the teams to get everybody in the same place at the same time to make this happen.”
Penn spent weeks recovering and rehabilitating in the hospital.
“We were really happy that she had progressed, had survived, honestly, and then progressed in inpatient rehab,” says Thompson. “It was wonderful to have the team, a lot of people who cared for her in the hospital, to celebrate her being able to go home.”
If not for ECMO, Penn would have likely died due to the time it would take to get her to another hospital with an ECMO program. Today, Penn is one of six lives the program has saved in its first year at Cone Health.
Penn notes that the entire staff treated her as if she were their own daughter or sister, spending time and praying with her.
Quandra Kock, RN, was the ECMO specialist on duty when Penn was admitted to the hospital and was part of the team working with Van Trigt during the life-saving procedure.
“I talked to the family to get a better understanding of Drea. As nurses, we take on that emotion with the family and the patient. Actually, we become family,” she explains. “Drea and I bonded because we both have kids the same age. During her care, I would follow up with her, motivate her and facilitate her getting better.”
Kock even made sure Penn’s minister connected with her often despite pandemic restrictions on visitation.
“Just because our patients leave the hospital, we don’t forget about them. They are attached to our hearts for the rest of our lives,” Kock says.
“Because I was in the hospital during COVID-19, I couldn’t have family with me all day, at all times. I hated being by myself without my family,” Penn recalls. “So, this celebration where I see everybody that helped me, took care of me, the doctors, staff and my family. It was really a great feeling for me. It was like that one moment of happiness that I needed the whole time I’ve been in the hospital. So, it was really nice for them to do that. I appreciate them a lot.”
Having been led out in a wheelchair, Penn triumphantly said, “Well, let me stand up and show them I can walk. Let me show them what I can do. Let me show them what they did to help me.”