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

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

Image of Medical personnel wearing masks, looking at paperwork on desk. Click to open a larger version of the image. 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...

Military Medical Units Support Civilian Hospitals Strained By COVID-19 Surge

Article
2/14/2022
Air Force Staff Sgt. Bradley Gorman, a medical technician assigned to a military medical team deployed to Yuma, Arizona performs a nasal swab at the Yuma Regional Medical Center’s COVID testing drive-thru in Yuma, Jan. 17, 2022.

Thousands of service members have been supporting civilian hospitals with testing, vaccinations and treatment of seriously ill patients.

Recommended Content:

Coronavirus

COVID-19 therapeutics support DOD pandemic response

Article Around MHS
2/11/2022
Military personnel getting COVID-29 doses ready

The U.S. Army Medical Materiel Agency is helping to protect the operational force by distributing several new therapeutic options that help to lessen the symptoms of mild-to-moderate cases of COVID-19 and keep Soldiers, their families and beneficiaries out of the hospital.

Recommended Content:

Coronavirus

COVID-19 Health Action Response for Marines continues to study long-term effects of COVID-19 on Marines

Article Around MHS
2/10/2022
Medical military personnel talking to a patient

A team composed of U.S. Navy medical personnel and civilian technicians based out of the Naval Medical Research Center in Silver Spring, Maryland, assembled during the initial outbreak of COVID-19 to study the short and long-term effects that the virus has on Marines. 

Recommended Content:

Coronavirus

Does CSM Gragg Have COVID-19?

Video
2/9/2022
Does CSM Gragg Have COVID-19?

CSM Gragg demonstrates how to use a COVID-19 at home rapid test.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | At-Home COVID-19 Tests | Coronavirus

Getting up-to-date on your COVID-19 vaccine

Article Around MHS
2/8/2022
Military personnel giving the COVID-19 vaccine

The U.S. Guard Coast is that we have vaccines to help prevent serious illness if you contract COVID-19.

Recommended Content:

Coronavirus

DOD COVID-19 Practice Management Guide Version 8

Technical Document
1/31/2022

This Practice Management Guide does not supersede DOD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

Recommended Content:

Coronavirus | COVID-19 Information for Military Treatment Facility Directors

Oregon National Guard surging to support hospitals again

Article Around MHS
1/27/2022
Oregon Army National Guard touring a hospital

Hundreds of Oregon National Guard members are increasing support of hospitals throughout the state in their second hospital relief mission during the COVID-19 pandemic.

Recommended Content:

Coronavirus | Readiness Capabilities

Public Health nurses offer insights on living with COVID-19 now, looking into future

Article Around MHS
1/25/2022
The Challenges of Living with COVID

One of the more challenging jobs for any public health professional is dealing with unpredictability inherent in outbreaks like the current COVID-19 pandemic.

Recommended Content:

Coronavirus

Do You Have COVID-19? Influenza? Or is it RSV? Here’s What to Look For

Article
1/24/2022
Military personnel preparing a COVID-19 test sample for processing

Knowing the symptoms of COVID-19/RSV/Flu will help your medical treatment

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Seasonal Influenza Vaccine Toolkit | Coronavirus

Medical Leaders Address COVID-19 Concerns During Family Forum

Article
1/21/2022
Navy Petty Officer 3rd Class Jemuel Macabali, from San Diego, Calif., gives the COVID-19 vaccine to staff at Camp Lemonnier, in Djibouti, Aug. 13, 2021.

Top health leaders talk about the recent spike in COVID-19 infections and the impact on the military community.

Recommended Content:

Coronavirus

Navy Hospital Corpsman steps into the breach in the war on COVID-19

Article Around MHS
1/18/2022
Hospitalman Hector Conde standing in front of a immunization office's refrigeration

First responders and those fighting on the medical battleground have earned well-deserved recognition for their efforts.

Recommended Content:

Coronavirus

Critically ill COVID Patient Delivers Baby While on Heart-Lung Bypass

Article
1/11/2022
Retired U.S. Marine Corps Gunnery Sgt. Carlos Hernandez and his wife, Ashley, take a family portrait with their six children. Ashley is BAMC’s first patient to give birth while on Extracorporeal Membrane Oxygenation.

Hernandez, a Marine Corps spouse and mother of five, is BAMC’s first patient to give birth while on Extracorporeal Membrane Oxygenation.

Recommended Content:

Women's Health | Coronavirus

Got Your 6 - Jan. 3, 2022

Video
1/4/2022
Got Your 6 -  Jan. 3, 2022

‘Got Your 6’ is TRICARE’s COVID vaccine video series that delivers important information and updates, on days that end in ‘6.’ It includes the latest information about DOD vaccine distribution, the TRICARE health benefit, and vaccine availability. Got a question about ‘Got Your 6’? Send an email to dha.ncr.comm.mbx.dha-internal-communications@mail.mil Find your local military provider at tricare.mil/MTF, or go to tricare.mil/vaccineappointments and schedule yours today!

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | COVID-19 Vaccine Efforts | Getting the COVID-19 Vaccine

This is my Why

Article Around MHS
12/30/2021
Air Force Senior Airman Marcus Bullock poses for a photo after receiving his COVID-19 vaccination

Air Force Senior Airman Marcus Bullock stated his reason for getting the vaccine was to help his mother and son be able to have a play date again.

Recommended Content:

COVID-19 Vaccine Efforts | Coronavirus

Development of WRAIR’s Pan-Coronavirus Vaccine Shows Promise

Article
12/28/2021
A vial of spike ferritin nanoparticle WRAIR's COVID-19 vaccine

Series of preclinical studies supports the Army’s pan-coronavirus vaccine development strategy

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | COVID-19 Vaccine Efforts
<< < 1 2 3 4 5  ... > >> 
Showing results 16 - 30 Page 2 of 32

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.