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NEWS | July 26, 2013

BAMC team makes medical history with heart-lung bypass mission

By Elaine Sanchez Brooke Army Medical Center Public Affairs

A Brooke Army Medical Center team made medical history recently by completing the military's first trans-Atlantic movement of an adult on external lung support.

A team of Army and Air Force doctors and nurses treated the patient with extracorporeal membrane oxygenation, or ECMO, during a nonstop C-17 Globemaster III flight from Germany to San Antonio - a 5,000-mile, 11-and-a-half-hour trek.

ECMO is a lifesaving heart-lung bypass system that circulates blood through an external artificial lung before sending it back into the patient's bloodstream, giving a critically ill patient's lungs or heart time to heal, explained Air Force Lt. Col. (Dr.) Jeremy Cannon, ECMO director and trauma chief at San Antonio Military Medical Center, BAMC's inpatient facility.

"This historic mission was a true demonstration of our commitment to caring for service members and their families," Cannon said, "no matter how ill or far away they are."

Cannon first learned of the patient, an active-duty Army spouse, late last month. She had been admitted to a German civilian hospital with a respiratory illness that was compounded by infection.

She was treated and released to a rehabilitation center, but a downward spiral in her health spurred her German providers to initiate ECMO.

The German doctors soon after contacted Air Force Lt. Col. (Dr.) David Zonies, medical director of the ECMO program at Landstuhl Regional Medical Center in Germany.

With Cannon's consensus, they decided the best course of action would be to bring the patient to SAMMC, where she could be provided expert ECMO care around the clock.

The hospital is one of a few adult ECMO-capable medical facilities in the nation.

The treatment is commonly used in neonatal intensive care units around the world on newborns, including at SAMMC, but adult applications are just now emerging.

Convinced by past successes and new data supporting the use of ECMO in adults, Cannon spearheaded the effort to offer the treatment here several years ago.

In October 2012, he oversaw the care of the hospital's first adult ECMO patient, and BAMC leadership officially stood up the program in May.

After the call from Zonies, Cannon swiftly assembled an ECMO team and flew to Germany while the patient was moved from the German hospital to Landstuhl.

The following morning, they boarded a C-17 and flew nonstop to Joint Base San Antonio-Lackland, where they arrived July 10.

A quick ambulance ride later, and the patient was admitted and moved to the ECMO unit in the U.S. Army Institute of Surgical Research Burn Center, located in SAMMC.

Although still on ECMO, the patient is doing well, Cannon said.

"She even asked for pancakes in Germany, but had to settle for a popsicle instead," he recalled with a smile. "But we made sure she got her pancakes here."

"The trans-Atlantic trip signified the last piece of the ECMO puzzle at BAMC," Cannon noted.

He had long envisioned a program in which ECMO patients could be transported directly from the battlefield to a stateside location, such as SAMMC, for their recovery.

The ultimate vision, he said, is to create a military ECMO network around the world to ensure wounded and other critically ill service members and beneficiaries can receive the most advanced care available anywhere.

"We've proven we can very safely take care of even most critically ill patients within the military health system," he said.

"I look forward to a future in which these types of missions aren't a 'first,' but a routine part of our mission."