New machine supports critical patients at Mercy Medical Center

This portable machine functions similar to the heart-lung machine, which sustains life during open heart surgery, according to perfusionist Chad Brady.

"I can't stress enough how reassuring it is to have that available," he said. "For example, working in the open heart room, if we have a patient we can't get on bypass, it's just nice to have that additional support if needed."

Brady gains vascular access through the patient's femoral artery in the groin or, if needed, the internal jugular vein in the neck. Blood is continuously drained from the patient into Cardiohelp. An artificial lung in the machine adds oxygen to the blood and removes carbon dioxide.

"There's also a pump within the device -- an artificial heart if you will -- that's providing cardiac support as well, removing blood from the patient to device and back to the patient," Brady explained.

Cardiohelp doesn't replace the heart-lung machine, according to Brady. He said that Cardiohelp, a 22-pound machine, can support the heart and lungs in a number of different places in the hospital beyond the operating room, from the intensive care unit to the emergency room.

A patient whose heart is in cardiogenic shock, a condition where the heart can't pump enough blood to meet the body's demands, can be placed on Cardiohelp following open heart surgery and then moved from the operating room to the intensive care unit.

"We're able to come out of the operating room. The patient could be on this device for a day or two here," Brady said. "With our resources, we're hoping not longer than two or three days."

Other situations where Cardiohelp can provide continuous support include a sudden blockage of an artery in the lungs, when blood pressure drops to a dangerously low level after an infection, and during life-threatening lung conditions that prevent enough oxygen from getting to the lungs and into the blood.

ECMO NETWORK

Cardiohelp, Brady said, is a fairly new device, but he said extracorporeal membrane oxygenation (ECMO) and Extracorporeal Life Support (ECLS) management have been around since the early 1970s.

The technology, he said, has advanced since then. Machines like Cardiohelp, which is dubbed the world's smallest portable heart-lung support system by its maker Maquet Cardiopulmonary, have become more compact. In the past, he said, devices were designed just to offer cardiac support. Now they offer both cardiac and pulmonary support all in one.

Brady and Kevin Christensen, the other perfusionist on staff at Mercy, completed a two-day training session to learn how to operate Cardiohelp.

"It is a complex device, but it's very simple to Kevin and I because we do it every day in the open heart room. It's the same concept to us, so it's easy to operate," Brady said.

Mercy Medical Center-Des Moines, The University of Iowa Hospitals and Clinics, and the Mayo Clinic in Rochester, Minn., are just a few of the hospitals that have Cardiohelp. Some larger medical centers, Brady said, are designated ECMO centers.

"If we had a patient on this device and after a couple of days it's being deemed they're gonna need long-term support, whether it's weeks or even months, then it will be very easy to transport the patient to those facilities," he said. "We pretty much just have to unplug from our unit and plug right into theirs."

Before Cardiohelp, Brady said patients needing respiratory support were transferred to bigger medical centers hooked to mechanical ventilators on high settings to oxygenate their blood and remove carbon dioxide. He said Cardiohelp gives patients a better chance of surviving transfer and ultimately recovering.

"Now we're able to put the patient on this device and set the ventilator settings to what they call a rest setting to allow the lungs to heal quicker," he said. "They're not being stressed to their maximum utilization to perform, so we're able to rest the lungs or the heart."