MORGANTOWN, W.Va. (WV News) – For the sickest patients with severe COVID-19 in the state, the lucky ones – now usually young adults – will have another chance at living with extracorporeal membrane oxygenation , more commonly known as ECMO.
ECMO is an advanced form of life support that essentially takes over the patient’s heart and lungs when the lungs cannot oxygenate the blood on their own. ECMO oxygenates the blood outside the body and then returns it to the patient’s body, saving more time for the patient’s treatment and recovery.
ECMO is for the sickest patients, those for whom “their only other option is really death,” Albert Wright, president and CEO of WVU Medicine, said of the technology.
Currently at WVU Medicine, the majority of patients on ECMO are between the ages of 20 and 35, said Dr JW Awori Hayanga, ECMO Program Director at WVU Heart and Vascular Institute.
“All of our patients on ECMO, really for the majority of the past 18 months, have been positive for COVID-19,” Hayanga said. “Not all, without exception, have been vaccinated.”
And there are many. The pandemic, and in particular the Delta variant, has maximized the capabilities of ECMO in the state.
ECMO beds at Charleston Area Medical Center have remained full since late June, according to CAMC spokesperson Dale Witte.
At WVU Medicine, consultations for ECMO care in early September were six to 10 per day, according to Hayanga.
The WVU Medicine ECMO service “has remained very busy and frequently looks after our maximum number of patients,” said Frank Briggs, vice president of the WVU Heart and Vascular Institute. “We have always had several patients waiting for the availability of an ECMO circuit. In addition, we had to turn away nearly 100 other patients due to lack of capacity. “
In August, the cabinet secretary of the state Department of Health and Human Resources Bill Crouch announced that the state would purchase additional ECMO units, which would go to CAMC and WVU Medicine, to increase the capacity of ECMO.
Prior to the state’s announcement, the Charleston Area Medical Center had ECMO units to serve three patients and has since received two more. Four more units are expected by the end of October or early November, according to Witte.
“This will allow us to expand our ECMO service to more patients in need of critical therapy. We are seeing an increase in severe cases of COVID in younger patients. We have been maximizing on patients since the end of June, ”said Witte.
Two additional units are intended for WVU Medicine. According to Briggs, the WVU Heart and Vascular Institute currently has dedicated equipment for seven ECMO patients, with the option to support an additional patient using equipment in the operating room.
“I hope that, along with the recruitment of staff, the additional equipment will allow us to provide this care to more critically ill patients in West Virginia. This year alone, we have evaluated over 200 patients and have declined the majority due to lack of resources. The moral distress of serving on the front lines as well as witnessing the pandemic carnage is wreaking havoc on our providers and healthcare workers, in particular. And we keep in mind that they are also at risk during this pandemic, ”said Briggs.
For patients who receive a WVU Medicine ECMO bed, 70% survived to ECMO removal and 67% survive to discharge. This survival rate exceeds the international benchmark of 50%, according to Hayanga.
Compared to last year, the average age of ECMO patients has decreased, and patients are less likely to have comorbidities like hypertension, diabetes and obesity at baseline, according to Hayanga.
The majority of patients are now between 20 and 35 years old, he said.
When asked if the young age of the patients was due to the facility’s triage practices, Hayanga said the average age of a referral is 40. Patients 50 years of age and older are either vaccinated and therefore usually do not get as sick, or are unvaccinated and die. too quickly to illness, he explained.
“Patients who get very sick and don’t die immediately tend to be the youngest now. This is a very different demographic that is affected compared to last year, so we didn’t have to adjust the age. The disease has adjusted the age for us, ”he said. “Patients over 50 – and this is a frightening statistic – during this Delta season have failed.”
For those unsure of the vaccination, Hayanga said he wished he could see what he sees.
“To these people, I wish I could take them into my life for one day and they would see. In our program, we care for the sickest patients with COVID-19 in the state. None of them are vaccinated, ”he said. “… In other words, not all sick patients we see are vaccinated. I do not see any vaccinated patients and I take care of the sickest patients in West Virginia.
Editor-in-Chief JoAnn Snoderly can be reached at 304-626-1445, by email at [email protected] or on Twitter at @JoAnnSnoderly.