Little did Sheena Leroy of South Boston know, as she went out on a hot Saturday night in July, that a few hours later, she would need ECMO, the highest level of life support, and a skilled team at Tufts MC to save her life. The petite 30-year-old partied with her girlfriends into the early morning, having fun after the work week. When she got home, she said she took over-the-counter medications to help bring the sleep she craved, taking more and more when they didn’t work.
Then, Leroy recalled her heart started “beating out of my chest, like I was going to die,” and she called 911. The ambulance got there fast; she told her fiancé she’d be back home in an hour. On the way to Tufts Medical Center, she started having trouble breathing. She was sweating and panicky. She heard one of the EMTs telling the driver to speed it up. That’s all she remembers until four days later.
By the time she arrived at the Tufts MC Emergency Department (ED), Leroy’s heart and lungs were badly damaged. In the ICU, her kidneys failed. She’s since been told she had only a 10 percent chance of survival and was given Last Rites. Leroy needed ECMO to provide her damaged heart and lungs with time to heal and give her a chance at life.
A Comprehensive Team; A Common Goal
ECMO is short for extracorporeal membrane oxygenation. It takes over the work of the lungs, heart or both. Very simply, here’s how it works: The patient is hooked up to the ECMO circuit via tubing that allows his or her blood to run through the circuit instead of through the heart or lungs. ECMO continuously removes carbon dioxide and adds oxygen and then returns the blood to the patient.
ECMO is relatively new to Tufts MC and Floating Hospital; it was first introduced in January 2013. It can be used for either adults or children, although adults are the Medical Center’s fastest growing group of cases. Tufts MC’s ECMO service is led by Medical Directors Karen Fauman, MD and Rashed Durgham, MD along with new Coordinator Leslie Smith, RRT. Cardiac Intensivist Adel Ghuloom, MD recently joined Tufts MC and with his extensive experience with ECMO, he will have a key role with the adult cases.
The ECMO service comprises a multispecialty team of more a dozen cardiologists, intensivists, cardiac surgeons, perfusionists and specially trained nurses and respiratory therapists. The nurses and respiratory therapists went through more than two weeks of rigorous classroom and hands-on training; they ensure adherence to strict policies and procedures.
“We’ve had some really great saves (of critically ill patients),” said Smith, who started working at Tufts
MC about a week before Leroy arrived at the ED. “ECMO is innovative and can save them like nothing else could.” It also allows the Medical Center to perform more complex cardiac surgeries than we could if we didn’t have ECMO available.
ECMO team members are encouraged and expected to speak up in the patient’s best interest. “The ECMO team is a great example of a multidisciplinary care model where everyone’s voice can be heard,” said Dr. Fauman. “The entire team is working together toward a common goal; we all really root for the patient.” Smith is excited about continuing to build the ECMO program and wants to work with the team to make Tufts MC and Floating Hospital an ECMO Center of Excellence.
Overcoming the Odds
ECMO helped Sheena Leroy beat the odds. Leroy’s heart and lungs healed enough in four days to once again do their jobs. While she faced rehabilitation and needed some continuing kidney dialysis, Leroy was optimistic.
“You never think something like this is going to happen to you…. I can’t thank the doctors and nurses—the whole team—enough,” she said. “They completely saved my life.”