Back to Top Skip to main content Skip to sub-navigation

BAMC expands use of ECMO to treat severe COVID-19 patients

Medical personnel wearing masks, looking at paperwork on desk Army Maj. Michal Sobieszczyk, staff physician, Interventional Pulmonology and Critical Care Medicine, reviews paperwork in a COVID-19 intensive care unit at Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas. (Photo by James Camillocci.)

Recommended Content:

Coronavirus

Extracorporeal membrane oxygenation, or ECMO, is a heart-lung bypass intervention that is proving to be lifesaving for some patients with COVID-19.

The staff at Brooke Army Medical Center at Joint Base San Antonio Fort Sam Houston in Texas has expanded the use of this highly specialized treatment in a “last line of defense” for critically ill COVID-19 patients. 

 “ECMO is often the last line of defense for the most critically ill patients with severe pulmonary disease,” said Air Force Col. (Dr.) Patrick Osborn, BAMC’s deputy commander for Surgical Services. “Whether due to COVID-19 or another condition, ECMO provides a life-support option that can potentially save lives when all other options are exhausted.”

BAMC, one of the few local facilities that offer the treatment, is currently providing up to one-third of the ECMO capability for the San Antonio area’s most severely ill community members, veterans and military beneficiaries suffering from the virus.

“As much as able, BAMC is easing the burden on local healthcare resources by admitting civilian ECMO patients,” Osborn said.

ECMO Explained

This treatment, which requires a multidisciplinary team of specially trained medical personnel, is used in the intensive care unit when a patient experiences heart and/or lung failure. The ECMO machine removes blood from central vessels in a patient’s body, circulates it through an artificial lung, oxygenates it, and delivers the blood back into the bloodstream. In essence, it replaces the natural functions of the heart and lungs while treatments and natural healing of the affected organs take place. 

“ECMO is not a treatment for any specific disease. It works by keeping critically ill patients alive and buying time for us to address their underlying condition,” explained Air Force Col. (Dr.) Phillip Mason, medical director for BAMC’s Adult ECMO program. “In some cases, we can reduce a patient's chance of dying from 80 to 90 % down to 30 to 40 %. While 30 to 40 % is still high, it represents a significant improvement and translates into many lives saved.”

Established in October 2012, BAMC has the only adult ECMO center in the Department of Defense and remains one of the few centers with global air transportable ECMO capability. The multi-service ECMO team has traveled around the global to pick up service members in need of the treatment.

While taking care of military beneficiaries is BAMC’s primary mission, the organization is able to support civilian ECMO patients through a special Department of Defense program. The experience gained ensures the ECMO team sustains the skills required to mobilize worldwide to treat and transport patients back to BAMC, Osborn said.

COVID-19 Care

Pre-COVID, BAMC averaged four ECMO patients at a a time due to the highly specialized personnel, training and equipment required to care for patients. In recent weeks, the hospital has expanded its capability and is treating up to nine patients at once, most whom are battling COVID-19. 

An ECMO team carefully considers the treatment after other lifesaving measures, such as oxygen therapy or a ventilator, have been exhausted.

“The vast majority of the critical care community believes that ECMO is effective as a rescue therapy for respiratory failure that does not respond to conventional therapies,” Mason noted. 

BAMC is part of a multinational observational trial of ECMO’s use for COVID-19 that should help to reveal evidence-based proof of the treatment’s effectiveness, Mason said. 

“While COVID is a complex disease effecting many organ systems, its primary manifestation is respiratory failure so there is at least some reason to believe ECMO will be effective,” he said, noting the treatment is often used for other viral respiratory illnesses, such as influenza.

With the program in place for nearly a decade, BAMC’s COVID team is accustomed to working closely with local hospitals in the event a patient may be a candidate for ECMO. This collaboration has stepped up in recent months, creating a larger influx of patients. 

To expand capacity to meet the growing community need, BAMC called on its ECMO team to train additional nurses and technicians on the equipment, while also leaning on personnel from the U.S. Army Institute of Surgical Research (ISR) Burn Center, which is housed in the hospital, to assist. 

“With the support of the ISR we have been able to expand our ECMO capacity significantly,” said Army Maj. (Dr.) Michal Sobieszczyk, Staff Physician, Interventional Pulmonology and Critical Care Medicine. "The BAMC and ISR bedside nurses have been instrumental in making the ECMO mission a success" 

Lifesaving Treatment

ECMO may be a last resort for COVID patients, but one that has proved lifesaving for many.

Sobieszczyk recalled one recent patient in his late 20s who was placed on ECMO two times, once for COVID-19 pneumonia, from which he recovered, and the second time for a bacterial pneumonia and sepsis. 

“He required a high level of support and came close to dying several times,” Sobieszczyk said. He was able to be weaned off ECMO and was decannulated (had tubes removed).

As a last-resort measure, ECMO is a high-stakes endeavor, Mason noted. “We have the highest highs and the lowest lows. But each life saved is incredibly rewarding for us, and a testament to the importance of this treatment.”

 “The ECMO team is honored to support the community during this pandemic,” he said. “Not only are we able to help the civilian population, but at the same time use this as an opportunity to enhance our mission readiness. It gives everyone a sense of purpose and mission, something we all strive for in the military.”

You also may be interested in...

DoD ready to help with Coronavirus, but capability limited

Article
3/17/2020
Misook Choe, a laboratory manager with the Emerging Infectious Disease branch at the Walter Reed Army Institute of Research in Silver Spring, Md., runs a test during research into a solution for the new coronavirus, COVID-19, March 3, 2020. The Emerging Infectious Diseases branch, established in 2018, has the explicit mission to survey, anticipate and counter the mounting threat of emerging infectious diseases of key importance to U.S. forces in the homeland and abroad. (U.S. Army Sgt. Michael Walters)

The DoD has only about 2% to 3% of the number of hospital beds that the private sector has

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

How DHA monitors the spread of health outbreaks

Article
3/13/2020
The Armed Forces Health Surveillance Branch (AFHSB) is the central epidemiologic resource for the U.S. Armed Forces, conducting medical surveillance to protect those who serve our nation in uniform and allies who are critical to our national security interests. AFHSB provides timely, relevant, actionable and comprehensive health surveillance information to promote, maintain, and enhance the health of military and military-associated populations. (U.S. Air Force photo by Tech. Sgt. Nathan Lipscomb)

The Defense Health Agency works as a combat support agency to the military services and Military Health System

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

DoD issues flexible instructions on response to Coronavirus

Article
3/13/2020
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). (CDC Illustration)

The memo covers aspects from before the outbreak through all levels of infection

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

Terry M. Rauch, Ph.D., M.P.H., M.B.A. Acting Deputy Assistant Secretary of Defense Force Health Protection and Readiness Regarding U.S. Biodefense and Response to the Novel Coronavirus Outbreak [Testified] Before the House Committee on Oversight and Reform

Congressional Testimony
3/11/2020

Recommended Content:

COVID-19 Vaccine Toolkit | COVID-19 Vaccine Toolkit | Coronavirus

COVID-19: Know what the terms mean

Article
3/10/2020
Soldiers stationed on U.S. Army Garrison Casey conduct pre-screening processes on individuals awaiting entry to the base, USAG-Casey, Dongducheon, Republic of Korea, Feb. 26, 2020. Additional screening measures of a verbal questionnaire and temperature check are in response to the heighted awareness of Coronavirus (COVID-19) following a surge in cases throughout the Republic of Korea and are meant to help control the spread of COVID-19 and to protect the force. (U.S. Army photo by Sgt. Amber I. Smith)

Learning the language can help you stay safe

Recommended Content:

Coronavirus | Public Health | Combat Support | Coronavirus

Coronavirus: What you need to know

Article
3/6/2020
A Guardsmen with the 341st Military Intelligence Battalion conducts translation work on a safety message regarding the best practices for avoiding the novel coronavirus for the Washington Department of Health on Feb. 9, 2020 at the Information Operations Readiness Center, Joint Base Lewis-McChord, Wash. (Courtesy Photo)

Although news stories and images contain many reports of people wearing surgical masks to ward off the virus, that's not recommended

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus

DoD makes plans to combat Coronavirus

Article
3/4/2020
Defense Secretary Dr. Mark T. Esper and Army Gen. Mark A. Milley, chairman of the Joint Chiefs of Staff, speak to reporters at the Pentagon, March 2, 2020. (DoD photo Lisa Ferdinando)

The number one priority remains to protect our forces and their families

Recommended Content:

Coronavirus | Public Health | Combat Support | Coronavirus

MHS prepared to support interagency coronavirus response

Article
2/6/2020
Airmen assist one another in donning their personal protective equipment, while on-board an Air Force C-17 Globemaster III during transportation isolation system training at Joint Base Charleston, South Carolina. Engineered and implemented after the Ebola virus outbreak in 2014, the TIS is an enclosure the Department of Defense can use to safely transport patients with diseases like novel coronavirus. (U.S. Air Force photo by Senior Airman Cody R. Miller)

From R&D to force health protection, MHS protects DoD personnel and families

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus

DoD releases guidance to protect forces from novel coronavirus

Article
1/31/2020
The novel coronavirus is a variant of other coronaviruses, such as this colorized transmission electron micrograph of Middle East respiratory syndrome (MERS) virus particles (blue) found near the periphery of an infected VERO E6 cell (yellow). Image captured and color-enhanced at the NIAID Integrated Research Facility in Fort Detrick, Maryland. (Photo by NIAID)

Basic infection controls offer best defense against illness

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus

Coronavirus: What providers, patients should know

Article
1/24/2020
Many forms of coronavirus exist among both humans and animals, but this new strain’s has caused alarm. (CDC graphic)

What to do now that virus has appeared in U.S.

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus
<< < ... 31 32 33 34 35 > >> 
Showing results 511 - 520 Page 35 of 35

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.