Liesbeth Stoeffler was an active woman in her 30s when she was diagnosed with cystic fibrosis, a genetic disease that, over time, leads to recurrent pneumonia, lung destruction, and ultimately death. By the time Liesbeth was in her 50s, her disease had progressed to the point that she needed lung transplantation – the only life-saving therapy for patients with cystic fibrosis. Unfortunately, Liesbeth developed complete respiratory failure while awaiting donor lungs. She required a mechanical ventilator to support her breathing. However, it was not enough to keep her alive. NewYork-Presbyterian/Columbia’s novel use of a cutting edge technology called ECMO (extracorporeal membrane oxygenation), was able to provide her the life-saving support she needed. Yet even this was not enough. In the condition she was in while on the ventilator and ECMO (deeply sedated and under muscle relaxants), she would soon become too weak to survive transplantation. Doctors Matthew Bacchetta and Daniel Brodie were able to use the ECMO in a new way, freeing her from the sedatives and muscle relaxants, waking her up and removing her from the ventilator. Able to participate in her care and get out of bed, Liesbeth was able to improve her functional status (rather than having it deteriorate) and could therefore maintain eligibility for lung transplantation while she waited for donor lungs to become available. ECMO improved Liesbeth’s oxygen and carbon dioxide levels, acting as an artificial lung, while eliminating her reliance on the mechanical ventilator. She could eventually talk and even use her laptop and cellphone. "About five days into it, she told me it was the best she'd felt in years," Dr. Bacchetta said. After 16 days on ECMO support, Liesbeth received the double lung transplant needed to save her life.
Patients may move around, eat, and even undergo pulmonary rehabilitation while on ECMO. Doctors at NYP/Columbia have been using ECMO technology as both a bridge to transplantation and a bridge to recovery, using it to treat patients with severe pneumonia, pulmonary fibrosis, cystic fibrosis, and other respiratory and cardiac diseases.