Friday, February 22, 2008

A Night at the U

I spent the night shift with my dad in the ECMO unit. Extra-Corporeal Membrane-Oxygenation. Outside-da-Body Blood-Oxygen-n-Chemistry. It's a way of completely bypassing organs and performing their function with machines. "It's not therapy, just life-support". He took me through the "circuit" and showed me how you keep a person alive with no heart, lungs, liver and kidney. It's a fancy technique that's still in it's infancy. Basically, the normal machine just functions as the lungs in the most benign configuration. Much of the time, you have to add the heart too. There are a variety of configurations, but with just heart and lungs failing, the success rates are good. In worse cases either the kidney or liver can fail. In the worst case, you have the 4 core organs gone... Basically, you're done at that stage. I guess the good news was, if you see my dad, you were already dead but now you have a chance of living. Success rates vary with age and diagnosis, but it's really good with young kids caught early with only heart and lung failure. If your liver fails (drinking, tylenol suicide attempt, etc) and then your other organs go, you got cornered into a horrible situation. Maybe you make it, more likely not. If you come in with multiple organ failure to begin with... make phone calls.

Dad with the machine on his left. Tubes, blood-bag, and machines.

This is the "patient". The blood that must be kept warm, oxygenated, chemically balanced and pumping throughout your body while you have no organs to do that.
Tube goes *into* your heart... Imagine doing that?
Your lung. This puts oxygen in and keeps the blood warm.

Your heart. The round part in the middle spins and pumps the blood.
A liver, should you need one.
And a kidney....The liver and kidney splice in to the blood strem with some extra tubing.... Hope you don't need them.

My dad's doing a lot of teaching and instructing at this point. Assembling the flight-ready unit:
In the neonatal unit with a tiny newborn or premie on the machine. The circuit is he two red boxes in front with the tubes. The meds and chemistry control is the bank of green lights on the left, spliced in to the blood flow circuit. Some kids are on it for months.

Crazy, huh?


Blogger Liz said...

Holy shit. Thanks for posting this! It's really interesting!

9:15 AM  
Anonymous Jeff said...

Holy crap. That's amazing. I like the "liver" and "kidney."

1:08 AM  
Blogger Jesse said...

Ok I know this is a total dick-hole comment, and everyone everywhere cringes when they hear this kind of stuff, including me BUT- should this baby really live? I mean common, how many signs does nature need to lay down to say, um yeah this genetic material should NOT be passed on...."Some kids are on it for months."

2:09 PM  
Anonymous Huck aka Dad said...

Responding to Jesse...through no fault of their own kids, infants get sick. Most illness in NOT genetic, just bad luck. With over 90% surviving this bad luck I'd say it is worth it. A month may seem like a long time...but everyone seems grateful to be alive regardless of duration of care... especially the parents. You are right, some genetic shit happens, but ECMO cannot reverse that and they do die. Huck

6:47 PM  

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