Children's Hospitals Today - Summer 2017 - 13

FROM EXPERIENCE / ROUNDS

The heart-lung machine
made cardiac surgery possible, but it caused lethal
blood damage when used
for more than an hour.
These
early
"artificial
lungs" delivered oxygen directly into the blood, which
turned out to be harmful
after a short time.
Bartlett and colleagues
set out to create a gentler
oxygen delivery system with
fewer side effects. Research
teams
developed
membranes to prevent oxygen
from contacting the blood
directly-the secret to extending the use of heart-lung
machines. Using membranes
for oxygen and carbon dioxide transfer allowed the
use of modified heart-lung
machines for days. The new
machine and technology
was called ECMO.
Bartlett and other researchers
wondered
if
ECMO could be used for
life support during severe
heart or lung failure. In
1975, Bartlett reported the
first neonatal survivor of
ECMO, a baby battling such
severe lung damage that
ECMO was used as a lastditch effort to save her life.
After seven days on ECMO,
she recovered. "Our wild
idea worked," Bartlett says.
"And it has continued to
work remarkably well in all
types of patients with heart
or lung failure."
But it took years of dogged
research and animal and
clinical trials-backed by
millions of dollars in federal
funding from the National
Institutes of Health (NIH).

And today, ECMO has
saved tens of thousands of
babies around the world,
including 2,500 patients
at U-M, according to the
Ann Arbor-based nonprofit
Extracorporeal Life Support
Organization.

PAYING IT FORWARD
As for Cheriyan, now 23, she
stumbled upon Bartlett's
name while studying biomedical engineering as an
undergrad. She sent him an
email reading, "Thank you
for saving my life." She went
on to spend four years as a
research assistant in his lab.
"It's a privilege to give back
to the research that made
such a difference in my own
life," she says. "I want to pay
it forward."
Tani Shtull-Leber, who
graduated from U-M Medical
School in May, is preparing

Bartlett "cloaks"
Hannah Cheriyan,
who as a baby
relied on ECMO
to save her life.

for an emergency medicine
residency in Phoenix and
also found his way from
the NICU to Bartlett's
lab. At birth, Shtull-Leber
experienced lung failure,
turned blue and was unable
to breathe. He was put on
ECMO at a St. Louis hospital
near his home. "My lungs
needed more time to develop, and ECMO bought me
that time," he says. "I would
not have lived past two days
without ECMO."
Decades later, ShtullLeber ended up in U-M
Medical School-the same
institution where his father, Steven Leber, M.D., is
a pediatric neurologist. And
Shtull-Leber also ended up
working with Bartlett in the
ECMO lab. "It was inspiring
to see how Dr. Bartlett and
everyone in his lab continue
to push the boundaries to

extend life," he says.
"We would not be able to
advance the field without
federal NIH funding to support ideas that may sound
'out there,'" Shtull-Leber
says. "It's important to support research even when it's
hard to see if there's going
to be a payoff. It's so hard to
predict when the next big
breakthrough or innovation
is going to be. ECMO is an
example of that."

ADVANCING ECMO
Today, the researchers in
Bartlett's ECMO lab remain
committed to work in the
field. Projects include using ECMO for an artificial
placenta to tackle extreme
prematurity,
optimizing
implantable artificial lungs
and extending the life of
organs before a transplant.
The medical industry
won't invest in these ideas
until research has proved
they work, which is why
federal funding is critical
to discovery, Bartlett says.
"What may seem like a pretty wild idea can someday be
a critical treatment."
"It's extremely satisfying
to see how far ECMO has
come. We periodically hear
from families who benefited
and heard we had something
to do with it. It's a great feeling, but also as scientists,
this is what we do. It's what
we are supposed to do."
Beata Mostafavi is a writer at
C.S. Mott Children's Hospital
in Ann Arbor, Michigan.
Tell your hospital's story. Email
magazine@childrenshospitals.org.

CHILDREN'S HOSPITAL S TODAY Summer 2017

13



Table of Contents for the Digital Edition of Children's Hospitals Today - Summer 2017

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