Program Overview

Extracorporeal Support Program

The Extracorporeal Support Program at the University of Tennessee Health Science Center (UTHSC) offers various extracorporeal therapies, including Extracorporeal Membrane Oxygenation (ECMO), Continuous Renal Replacement Therapy (CRRT), and Apheresis.

About ECMO

Extracorporeal therapy is a procedure where blood is removed from a patient's body, medical therapies applied to it prior to its return to the patient's body. The ECMO team at UTHSC provides ECMO, CRRT, and Apheresis, while the Heart Failure and Transplant team provides Ventricular Assist Device (VAD) support.

Turning Heads, Saving Lives

ECMO provides temporary support of heart or lung function using mechanical devices. The process involves continuous drainage of venous blood to an extracorporeal circuit, removal of carbon dioxide and addition of oxygen via an artificial lung, and returning blood to the patient using a mechanical heart. There are two types of ECMO: Veno-venous, where the blood is removed and returned to the veins, and Veno-arterial, where the blood is taken from vein/s and returned to an artery.

ECMO Treatment

ECMO treats infants and children with respiratory failure, heart failure, septic shock, and cardiac arrest. Patients with respiratory failure secondary to ARDS, meconium aspiration, persistent pulmonary hypertension, status asthmaticus, and other respiratory illnesses can be treated with Veno-venous ECMO. Patients with cardiac failure, septic shock, and cardiac arrest are usually placed on Veno-arterial ECMO.

ECMO Run

The ECMO "run" is the time period when a patient is on ECMO support. The four stages of the run are:

• Cannulation: when a patient is placed on ECMO
• Recovery stage: when the patient is resting on ECMO
• Weaning: when the patient's ECMO support is decreased
• Decannulation: when the patient is detached from ECMO support

ECMO Leaders at Le Bonheur

At Le Bonheur Children's Hospital, utilization of ECMO has contributed to saving the lives of the most critically ill children. The ECMO program was initiated in March 1990 by Dr. Mark Bugnitz and Deborah Chyka, RN, and has treated more than 380 patients to date. The current leaders of the ECMO team are:

• Dr. Hitesh Sandhu (Medical Director)
• Dr. Samir Shah (Associate Medical Director)
• Samantha Ransone, RN (ECMO/Apheresis Coordinator)
• Morgan Melancon, RN (ECMO/Apheresis Coordinator)

Other Extracorporeal Therapies

The ECMO team also provides CRRT and Apheresis. CRRT is used to treat renal failure and fluid overload, and is a steady continuous procedure in a sick patient who might not tolerate intermittent dialysis. Apheresis involves separation of plasma from the rest of the blood and its replacement with other fluids, and can be used to treat various diseases due to abnormal antibodies or absence of certain blood factors.

Extracorporeal Life Support Organization

The Extracorporeal Life Support Organization (ELSO) is an international consortium of health care professionals who promote collaboration in the development and evaluation of therapies to support failing organ systems. Le Bonheur Children's Hospital has received the ELSO Award for Excellence in Life Support three times, recognizing its exceptional and extraordinary achievement in promoting the mission, activities, and vision of ELSO, patient care, and training, education, collaboration, and communication.