Leverkusen –
If nothing helps and even ventilation machines can hardly save a human life, there is one last chance: it is called extracorporeal membrane oxygenation, or ECMO for short. At first glance, this machine looks quite inconspicuous. But behind state-of-the-art technology hides an artificial lung that is technically similar to a heart-lung machine. The Leverkusen Clinic has recently acquired such a device, which can also be used for Covid 19 patients if necessary. Indirectly, the timely purchase of the 90,000-euro device was only possible due to the pandemic. Because the financing came from federal and state funds.
Professor Dr. Gerd Peter Molter, Director of the Clinic for Anesthesia and Operative Intensive Care Medicine: “We bought this device to offer patients with severe lung failure or combined lung-heart failure an ultimate therapy option.” In other words: the use of artificial lungs is dangerous, but also without alternative. Because the only alternative would be suffocation.
The ECMO has been used again and again in recent years. However, the doctors had to borrow a device. For example in the years of the flu wave in 2017 and 2018. “There were quite a few lung failures and we had the device in multiple use,” recalls Dr. Christian Mey, responsible senior physician in the intensive care unit with Covid 19 patients. Renting the machine takes around twelve hours in advance. That is a clear restriction of the ability to act when it comes to survival. Now the device is immediately on the spot and ready for use within two hours.
It is needed above all when a patient’s own lungs can no longer cope with the vital gas exchange. The ECMO can replace the lungs almost completely over days or weeks. According to Mey, a patient whose lungs were severely damaged was even ventilated in this way for 50 days. By oxygenating the woman’s blood outside her body, the lungs were given enough time to recover.
To put it simply, the system works with the help of a pump that conducts up to six liters of blood per minute outside the body through a membrane oxygenator, which in turn removes carbon dioxide from the blood and at the same time enriches it with oxygen. The prepared blood is then returned to the body.
Mey sees the machine as “a technical achievement with which one can help people, but also needs well-trained nursing staff who are able to operate this device.” This is one of the reasons why its use is seen as the last possible therapy. The ECMO does not cure a disease, but is often the last option for patients. The machine is currently not in use. “But I reckon it will need around four to eight missions a year,” the doctor estimates.
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