ECMO Patient Survives Acute Respiratory Failure; Proposes to his Girlfriend in ICU

Sarah and Chris Costa at their wedding, May 14, 2011

On March 20, 2010, Chris Costa, a 26-year-old paramedic in Connecticut, was taking a quick ride on his motorcycle when he was sideswiped by a truck. He sustained serious trauma, including seven broken ribs and a broken right femur, and was rushed to St. Vincent’s Medical Center in Bridgeport. While there, he developed acute respiratory distress syndrome, or ARDS, a condition in which the lungs fill with fluid. He was put on a mechanical ventilator, to no avail; his lungs stopped working, and his kidneys soon followed. Recognizing that Chris’s life was in danger, his cardiothoracic surgeon, Dr. Albert Dimeo, called Daniel Brodie, MD, Director of the Medical ECMO Program at NewYork-Presbyterian Hospital/Columbia University Medical Center, and asked that Chris be put on ECMO.

ECMO stands for extracorporeal membrane oxygenation. When human lungs are functioning normally, they add oxygen to the blood and remove carbon dioxide from it. But when they are failing, as in Chris’s case, ECMO can perform this vital function for them. The patient’s blood is run out of the body, through the ECMO machine, and back in, through a system of tubes; the ECMO machine essentially serves as a set of out-of-body lungs, continually oxygenating the blood. Because this advanced technique allows the patient’s lungs to rest, it avoids causing the damage and complications associated with other techniques, such as mechanical ventilation. According to Dr. Brodie, “It is a technique with the potential to save many lives.”

On March 24, four days after the accident, NYP/Columbia rushed their mobile ECMO Transport Team to St. Vincent’s, where Matthew Bacchetta, MD, MBA, MA, Director of the Adult ECMO program, and his team put Chris on ECMO. He was then transferred to NewYork-Presbyterian/Columbia University Medical Center (via police escort — he also worked for the Fairfield police at the time), where Dr. Brodie, Dr. Bacchetta, and the rest of the ECMO team continued to provide and monitor Chris’s ECMO support.

Chris’s condition gradually improved; when he regained consciousness about two weeks later, although still breathing through a hole in his neck know as a tracheostomy, he was already cracking jokes. His family and girlfriend of five months (Sarah, a Connecticut policewoman with the Bridgeport police) were there with him. He could hardly speak, however, due to the tracheostomy. It was so difficult to talk, in fact, that his mother had brought him a whiteboard so that he could avoid the effort of speaking.

One day, still in the ICU with his tracheostomy, Chris sent Sarah a text message as she was out getting dinner with a friend — asking her for her hand in marriage. She dropped her food, ran back to the ICU, and accepted his proposal. It was the first engagement the Columbia ICU had ever seen.

Several weeks later, as his recovery continued, Chris devoted an afternoon with his occupational therapist to mastering the difficult task of climbing out of bed, getting down on one knee, and climbing back into bed. That evening, Sarah came to visit him in his hospital room. Chris asked her to close the door. She walked to the door saying “shouldn’t you do this by yourself,” and when she turned around, she found him kneeling before her, presenting a wedding ring — their formal proposal.

After about two and a half months, Chris and Sarah left the hospital and went home. Chris has made a full recovery, and the two are even riding again. But as Dr. Brodie warns, the happy outcome might have been different if St. Vincent’s Medical Center hadn’t provided such outstanding initial care and if Dr. Dimeo hadn’t thought to call upon the NYP/Columbia team to put Chris on ECMO as soon as he did. “ECMO is proving to be valuable therapy in the most severe cases of ARDS,” he says. Drs. Brodie and Bacchetta hope that stories like Chris’s will help spread the word about ECMO, and the lives it has the potential to save.