NYP Brooklyn Methodist

I S E C M O F O R E V E R Y O N E ? Extracorporeal membrane oxygenation (ECMO) is a highly sophisticated procedure that allows a machine to take over the work of the heart and lungs, keeping patients alive so they can be treated and have a chance at recovery. This technology is traditionally used to save the lives of infants who have serious health issues, such as pneumonia or heart failure, or to keep patients alive during heart surgery. Its use to help heart attack patients like Robert Espinoza is a more recent development, and it is one that few hospitals and their staffs have the ability to provide. Not every patient who comes to an emergency department in cardiac arrest will benefit from ECMO. ECMO treatment takes several days, and older patients or a patient with other health issues may not tolerate it for that long. Ideally, the cardiac incident should be witnessed and cardiopulmonary resuscitation (CPR) should begin right away because just 10 minutes without blood flow is long enough for the brain to begin to die. ECMO cannot restore damaged brain tissue. Although Robert's event was not witnessed, he qualified for ECMO due to his young age and apparent overall health. The procedure ultimately saved his life. determine what caused his heart attack and assess and implement the best course of treatment. TIMELY INTERVENTION Robert was moved from the ED to the cardiac catheterization lab, where Terrence Sacchi, M.D., interventional cardiologist and chief of cardiology at NYM, diagnosed the problem. In the cath lab, Dr. Sacchi injected a special dye into Robert's veins, and x-rays were used to take pictures of the dye as it wound its way through the vascular structure of Robert's heart. "The images showed us that Robert's left anterior descending artery was completely blocked," Dr. Sacchi says. "I was able to open the artery, restoring the blood flow with a stent coated in medication to help the artery remain open." After the atery was cleared, Robert was moved to the cardiac intensive care unit at NYM. "After his procedures, Robert started to improve," recalls Nancy Rizzuto, C.C.R.N., associate director of cardiovascular nursing. "His heart got stronger, and his neurological function was measured daily. It took him several days to wake up so that we could fully assess his neurological status. He did amazingly well." Not only did Robert survive a massive heart attack, but aside from slight memory loss, he appeared to be 100 percent intact neurologically, meaning he had suffered no brain damage. He responded to doctors' inquiries, asked intelligent questions and was happy to see the steady stream of friends who flocked to the Hospital to visit. "Without the exceptional care Robert received, first in the street, then in the emergency room and ultimately at the hands of Dr. Gulkarov, the ECMO team and Dr. Sacchi, he wouldn't be here today," Dr. Peterson says. "Rapid intervention made all the difference." Similarly, Dr. Gulkarov believes the ED's smart decision to activate the ECMO team and the rapid implementation of ECMO are what saved Robert's life. MOVING FORWARD Today, Robert spends time with friends and pursues his favorite hobby, reading. He is rebuilding his strength and venturing out again to eat at nearby restaurants. Robert is moving forward with life, but he'll never forget the care and support he received at NYM. "When people start throwing around the word 'miracle' to describe what happened to me, I know I experienced something truly amazing at the Hospital," he says. "It's so wonderful to be able to walk through my neighborhood again, visit my favorite bookstore and socialize with friends. As I continue to recover, I see how much I've grown through this process. I owe my life to the team at NYM." " ECMO is a game changer. It lets us pull people back from death's jaws and give them a chance to live again. " —STEPHEN PETERSON, M.D., CHAIR OF THE DEPARTMENT OF MEDICINE AT NYM " When people start throwing around the word 'miracle' to describe what happened to me, I know I experienced something truly amazing at the Hospital. " —ROBERT ESPINOZA, NYM PATIENT thrive thrive thrive thrive thrive thrive thrive thrive thrive thrive thrive thrive thrive P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE 15 P H Y S I C I A N RE F E R R A L / / 718 . 49 9. C A RE

• Cover