Doctors at a Brooklyn hospitals are removing coronavirus patients’ blood from their bodies, rejunvenating it with oxygen, and returning it to the patients in an experimental bid to help those on ventilators.
The procedure is known as ‘ECMO’ – extracorporeal membrane oxygenation.
As critically ill coronavirus patients flood into their hospitals, doctors have noticed a bizarre trend.
Even those who aren’t struggling to breathe and don’t yet show signs of oxygen deprivation have such low levels in their blood that a lab report would suggest they’re already dead, Stat News reported.
Putting these patients on ventilators for extended periods may damage their already fragile lungs, and in New York City, 80 percent of ventilated patients are dying.
In an effort to alleviate these deadly issues, Dr Paul Saunders and his colleagues at Maimonides Medical Center in Brooklyn, where more than 23,000 people have coronavirus, are using ECMO to put oxygen straight into patients’ blood, according to Good Morning America.
ECMO removes blood from a patient, enriches it with oxygen, then pumps it back into their bodies in an effort to supplement mechanical ventilation for critically ill coronavirus patients
Coronavirus has a spike protein that attaches to lung cells, hijacking their machinery to replicate itself.
It typically enters the body through the nose or mouth then travels down the airway toward its goal, deeper in the lungs.
There it damages the branches of the respiratory tree, a network of passageways, then on to the tiny sacs in the lungs responsible for gas exchange.
This triggers an immune response that rushes white blood cells to the site of the infection in an effort to eliminate the viral invader.
But because the virus that causes COVID-19 is totally unfamiliar to the immune system, it doesn’t have antibodies designed to fight it.
So the inflammation keeps pouring in, eventually building up in those air exchange sacs, called alveoli, and keeping them from being able to take in oxygen to distribute to the body and expel carbon dioxide.
Dr Paul Saunders is a heart surgeon leading the charge to use ECMO for COVID-19 patients. He himself survived coronavirus and is now back to work in the ICU at Maimonides Medical Center
At this stage, a patient has pneumonia, and if it persists, the lungs start failing.
Mechanical ventilation can breathe for them, but it isn’t always enough to save a patient’s life and the invasive supportive care itself can damage the lungs by forcing highly pressurized air into the lungs and over-saturating them with oxygen.
An analysis of ventilated patients in New York City found that at least 80 percent of them die. Already
Still, ventilators are, broadly speaking, the best hope for critically ill coronavirus patients, but they’re in short supply.
So doctors are racing to find alternatives or supplements.
At Maimonides, they’re turning to ECMO.
Dr Saunders (not pictured) refers to ECMO as a ‘last resort’ for patients for whom ‘ventialtion is not enough’ to keep their blood oxygen levels high enough
ECMO works similarly to heart and lung bypass machines used during open-heart surgeries, mechanically pumping blood and air for the patient while they are undergoing the procedure.
The machine used for ECMO removes blood from the body, uses an artificial lung to infuse oxygen into starved red blood cells, then pumps that rejuvenated blood back into their bodies, helping to prevent cell death in tissues deprived of oxygen.
‘In the current epidemic it’s used as a last resort when ventilators aren’t enough,’ Dr Saunders, a heart surgeon at Maimonides Medical Center told GMA.
Dr Saunders himself caught coronavirus, but survived and is now back to work in the ICU.
He said that some of the patients on the ward are in their 30s and 40s.
‘It’s very hard to predict who’s going to get very sick and who’s not,’ Dr Saunders said.
The hope is that the method can be a secondary aid for patients on life support, help to limit the damage ventilation may cause to their lungs and supplement the short supply of ventilators.
New York City had a stockpile of some 3,500 ventilators when coronavirus started spreading in the metropolis, according to ProPublica.
Mayor Bill de Blasio said last week he thought the city would run out of ventilators over the weekend.
The crisis was averted, for the moment, but the threat of ventilator shortages is far from over, with more than 87,000 people in the city infected with COVID-19. n