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Can ECMO Help Rural Hospitals Save More Lives?

Analysis  |  By Eric Wicklund  
   May 16, 2024

Health systems in Minnesota and Nevada are getting more than $30 million in grants to support ECMO programs, which treat patients with severe heart and lung  conditions

A global philanthropy is donating more than $31 million in grants to health systems in Minnesota and Nevada to expand access to innovative life support technology that could help save lives in rural areas.

The Leona M. and Harry B. Helmsley Charitable Trust has issued a $19.7 million grant to the University of Minnesota to support its Mobile ECMO (extracorporeal membrane oxygenation) program and has made grants totaling $11.6 million to three Nevada health systems to expand their ECMO services across the state.

“ECMO can be a game changer for patients with severe heart and lung conditions,” Walter Panzirer, a trustee with the New York-based organization, said in a press release. “Without ECMO, hospitals have to transfer patients to other facilities, and those who are too unstable for transport could die before receiving needed care.”

ECMO provides prolonged cardiac and respiratory support for people whose heart and/or lungs are unable to provide an adequate amount of oxygen, gas exchange, or blood supply to sustain life. The technology used is similar to a cardiopulmonary bypass machine, and the device used is a membrane oxygenator, also known as an artificial lung.

As profiled in a November 2023 story in Scientific American and a March 2024 story in The New York Times Magazine, ECMO technology could be used during CPR—in a process called ECPR, or extracorporeal cardiopulmonary resuscitation—to treat patients in cardiac arrest at accident and disaster scenes and rural locations. The procedure has been in use for more than a decade in France, is being trialed in the Netherlands and was first performed in the U.S. by emergency physicians in 2019 at the University of New Mexico.

The procedure has the support of the National Institutes of Health, which ended a 2020 clinical trial at the University of Minnesota early, saying it would be unethical to deprive eligible people of the treatment, after it was reported that ECPR resulted in a survival rate of 43%, compared to 7% in traditional care. Other studies haven’t been so positive, including one published in 2023 in the New England Journal of Medicine, which compared ECPR with standard care across 10 medical centers in the Netherlands and found little difference in survival rates.

In Minnesota, the Helmsley trust has given $19.7 million to the University of Minnesota to expand and sustain a mobile ECPR program launched in 2022 with a van specially fitted with ECMO technology.

In Nevada, the trust is granting more than $5.1 million to the St. Rose Dominican Health Foundation to launch an ECMO program at Dignity Health-St. Rose Siena Hospital in Henderson. The grant will be used to add four dedicated ICU rooms and an adjacent sleep room for patients suffering from acute respiratory distress, recovering from cardiac arrest, or awaiting a heart or lung transplant.

(The foundation is also getting a $1.7 million grant to help renovate the hospital’s four cardiac catheterization labs and upgrade vascular disease imaging services for patients with coronary artery and structural heart diseases.)

Another $3.5 million will go to the Renown Health Foundation to establish an ECMO program at Renown Regional Medical Center in Reno, the first such program in the northern part of the state.

A $1.2 million grant to University Medical Center of Southern Nevada, initially made in 2023, helped to create a program with four ECMO machines, and the health system plans to add another seven machines in the near future.

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.


KEY TAKEAWAYS

ECMO technology offers prolonged cardiac and pulmonary support for patients whose heart and/or lungs aren’t functioning.

Supporters say the technology could save lives in accidents, disasters, and rural regions where access to emergency care is limited. Others say the process is costly, complex, and unproven.

The Helmsley Charitable Trust is granting more than $31 million to health systems in Minnesota and Nevada to launch or expand ECMO programs.


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