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Heart-Lung Machine Providing Life-Saving Treatment To Severely Ill

PITTSBURGH (KDKA) -- A machine created to help with heart surgeries is quickly becoming used for a lot more. In fact, a local woman says it single-handedly saved her life.

Nearly two years ago, Pat Scarano was severely ill with the H1N1 flu.

"Yes, they were concerned because I was completely comatose," says Scarano, of Murrysville.

She was so sick that she had to be put on a heart-lung machine for eight weeks.

"They weren't sure what I would be like when I woke up," she says.

She doesn't remember any of it, but her sister kept a scrapbook to fill in the missing time. Every day it was day-to-day, which was tough on her husband and two sons.

"He sat down beside me and said, 'Mum, I didn't think I'd ever hear your voice again,'" said Scarano. "And that's when I realized that's how awful it must have been for them."

Her treatment with the heart-lung machine, also called ECMO - for extracorporeal membrane oxygenation - is a growing trend.

It was initially developed for use during open heart surgery, but it turns out, it can also help people with failing hearts or failing lungs, especially when medicines, ventilators, and pumps are either not working, or actually harming the patient.

"So, ECMO is sort of a way that we can take over the lung function and rest the lungs while they heal," Dr. Robert Moraca, a cardiothoracic surgeon at Allegheny General Hospital, said.

The machine and its supplies are on a mobile cart that can go anywhere in the hospital. An ECMO team is called into action when a patient's condition is deteriorating.

The team may have hours of notice, for example with an ICU patient, or just minutes with a patient getting CPR in the emergency room.

The machine takes dark, unoxygenated blood from the body, puts this vital gas back in, and the bright red, invigorated blood is then returned to the body. This involves putting large tubes into major blood vessels. Damage to these vessels is a risk.

"The tubes can be as big as your finger or thumb," says Dr. Moraca. "These things go in sometimes in the heat of action, when people are rapidly deteriorating."

People can stay on the machine for weeks, depending on the problem. Outcomes often depend on how healthy they were to begin with.

Most people who go on ECMO would have a very low survival rate without it, usually less than five percent. With ECMO, survival can be 50 percent.

"It's a dramatic increase in survival, but more than anything it buys us time to allow patients to heal," Dr. Moraca said.

But it's not available everywhere, or if it is at a community hospital, patients are often transferred to a bigger academic medical center to manage the treatment.

Allegheny General Hospital has seven ECMO machines. In fact, Scarano was one of several H1N1 flu patients on ECMO at the same time. But one patient died while Scarano's family was in the waiting room with the deceased's family.

After a long recovery, Scarano is back to her normal self. When she looks back on the experience, she realizes things could have turned out very differently.

"If it wasn't available, I know I wouldn't be here," she says.

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