The Extracorporeal Life Support Organization (ELSO) designated Inova Fairfax Medical Campus a Gold Level Center of Excellence for extracorporeal membrane oxygenation- a therapy that has been successful in treating some of Inova’s most critically ill patients, including those with COVID-19.
Extracorporeal membrane oxygenation (ECMO) is a life support machine that is used during life-threatening reversible conditions that hinder the heart or lungs from working properly. This machine replaces the function of the heart and lungs by pumping blood from the patient’s body to an artificial lung that adds oxygen and removes carbon dioxide. The ECMO machine then sends the blood back to the patient via pump with the same force as the heart. Taking blood from a patient’s body and passing it through a machine that can provide support for the heart and lungs is an invasive and risky process, and exposes patients to risks for bleeding, infection and organ failure.
As a form of long term heart-lung bypass, ECMO can be used for weeks to months to support patients with failing lungs, heart, or failing heart and lungs. It can also be used as a bridge to recovery for organ transplants or durable devices, such as cardiac ventricular assist devices. When used in carefully selected patients with reversible conditions or those who are transplant candidates, ECMO can provide time for the body to heal or for a patient to obtain the organs they need.
Over the last decade, advances in technology and critical care have aided the rapid growth of ECMO therapy in adults. Most recently, ECMO has been used as a life-sustaining treatment for some of Inova Fairfax Medical Campus’ most critically ill COVID-19 patients. This treatment has supported some patients in their recovery, allowing them to recover from this new disease.
“Over the past six years, ECMO has been an invaluable and necessary support modality for our patients in IHVI with failing cardiovascular and pulmonary diseases who are otherwise unable to be supported by more routine methodologies. We have assembled an excellent clinical staff with our cardiac surgeons, Medical Critical Care Pulmonary ECMO specialists, nurses with special expertise in this technology, respiratory therapists, and ECMO technical support staff to provide care to our patients with outcomes that represent some of the best results in the US. This was recently demonstrated by the exemplary results in our IHVI in support of the COVID-19 pandemic in those patients with end-stage respiratory failure. Inova is proud of our excellent clinicians and our ability to provide such treatment to the appropriate patients in our region,” comments Alan M. Speir, Chief, Extracorporeal Membrane Oxygenation (ECMO) Program, Inova Health System.
The ECMO Program also had the honor of presenting to an international audience during an Extracorporeal Life Support Organization (ELSO) webinar at the onset of the pandemic, allowing for the program’s successful management methods to be adopted at numerous ECMO centers in the United States and worldwide. Our program continues to assist other facilities save the most severely ill COVID-19 patients by organizing regional collaboration among major centers in order to share resources and provide access to ECMO experts.
“Initially, there were mixed reports about the efficacy of ECMO use in COVID-19 patients. Inova was one of the first large programs in the United States to use ECMO successfully on a large number of patients. These inspirational success stories helped provide hope in the face of much of the negative press regarding COVID-19 patient outcomes,” comments Erik Osborn, MD, Medical Director, Extracorporeal Membrane Oxygenation (ECMO) Program, Inova Health System.
Inova Fairfax Medical Campus has expanded the ECMO program since its founding in 2016. Eight years prior to development of a formal program, Inova offered ECMO only as a rescue therapy. The program has grown from 15-20 cases per year in 2015 to roughly 150 cases per year today, providing services to both pediatric and adult patients. The program includes a team of cardiac specialists from a variety of disciplines such as vascular surgeons, cardiologists, intensivists, ICU nurses, OR nurses, respiratory therapists, ECMO specialists from both critical care and lung services, advanced practice providers and perfusionists.
In July of this year, ELSO designated Inova Fairfax Medical Campus a Gold Level Center of Excellence. ELSO is an international non-profit consortium of health care centers and individuals who are dedicated to the development, evaluation and improvement of ECMO and other innovative therapies for support of failing organ systems in the neonate, child and adult.
The Excellence in Life Support Award recognizes those centers that demonstrate an exceptional commitment to evidence-based processes and quality measures, staff training and continuing education, patient satisfaction and ongoing clinical care. As a designated Center of Excellence, Inova Fairfax Medical Campus has demonstrated extraordinary achievement in the following three categories:
- Excellence in promoting the mission, activities, and vision of ELSO
- Excellence in patient care by using the highest quality measures, processes, and structures based upon evidence
- Excellence in training, education, collaboration, and communication supporting ELSO guidelines that contributes to a healing environment for families, patients and staff
The ELSO Award demonstrates that Inova is one of the leading programs in the world setting the standard for delivery of extracorporeal support. The ECMO Program at Inova has also rapidly become one of the highest volume programs in the United States and the world. During the COVID-19 pandemic ECMO volume doubled – even tripled in size – as Inova Health System expanded to meet the demands of the northern Virginia and Washington DC region. “ECMO is a multidisciplinary enterprise and the Inova ECMO Program’s success during COVID-19 demonstrated effective teamwork across the system. Inova rose to the occasion and met the demands of the population it serves. Inova now has an opportunity to expand its infrastructure and ECMO will be a key component of Inova Health System’s growth and expansion into a world leader as a quaternary major healthcare leader. Currently, we are in the process of re-evaluating the ECMO program and will design a plan to continue to expand it in a safe and effective way,” Erik Osborn, MD, says of the future of Inova’s ECMO Program.