Too Few Hospitals In COVID Hotspots Are Equipped To Offer ECMO : Shots - Health News ECMO, the highest level of mechanical life support, functions as a temporary heart and lungs for some of COVID-19's sickest patients. But the waitlist is too long for many patients who need it.

Across The COVID-Ravaged South, High-Level Life Support Is Difficult To Find

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STEVE INSKEEP, HOST:

A sophisticated medical technology is helping to buy time for patients whose lungs are damaged by COVID. The technology is called an ECMO machine. It provides the highest level of life support beyond a ventilator by pumping the patient's blood outside the body to be oxygenated mechanically. So many people need this, though, in the South that there are waiting lists to get it.

Blake Farmer of WPLN in Nashville reports.

BLAKE FARMER, BYLINE: Its discharge day for Phoua Yang.

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FARMER: In mid-August, the 38-year-old mother received pep rally treatment on her way out of Centennial Medical Center in Nashville, complete with streamers and confetti. She is living proof of the power of ECMO and why the treatment has become such a pinch point.

PHOUA YANG: One-hundred-forty-six day is a long time.

FARMER: For nearly five months, Yang had blood pumping out a hole in her neck and running through a rolling cart by her bed. She had a one-on-one nurse that whole time, and often many more than that.

YANG: At least four to maybe sometime five people to help me.

FARMER: When she needed to get up each day and walk to help her heal, one person's job was just to make sure no hoses kinked and potentially killed her.

Nurse Kristin Nguyen works with ECMO patients at Vanderbilt University Medical Center. She says, they require more time and attention than anyone in the ICU.

KRISTIN NGUYEN: These patients take so long to recover. And they're eating up our hospital beds 'cause they come in and they stay.

FARMER: It's not that there aren't enough ECMO machines to go around. It's that there are so few hospitals that even offer ECMO, which is a high-risk intervention.

HARSHIT RAO: We are flowing a lot of blood through those machines. There is no room for error.

FARMER: Dr. Harshit Rao oversees critical care for Envision, which staffs ICUs with physicians. He says, you wouldn't want people without experience trying it out. Before COVID, transferring a patient to the nearest major medical center for ECMO wasn't a big deal. But now the ICUs are full.

RAO: We have to make tough choices. So that's really what it comes down to is, how sick are you, and what's the availability?

FARMER: This wasn't as much of a problem earlier in the pandemic, when most of those dying were older. ECMO is rarely used for people over 65. But the calculation is different for the younger people who make up this wave of largely unvaccinated COVID patients.

Dr. Mani Daneshmand is with Emory University Hospital.

MANI DANESHMAND: When you have a 30 year old or a 40 year old or someone who's just become a parent, you're going to call. And we've gotten calls for 18 year olds.

FARMER: Daneshmand says, even as big as Emory is, the Atlanta hospital is turning down COVID transfers every day.

DANESHMAND: There's a lot of people who are very young who are needing a lot of support. And a lot of them are dying.

FARMER: Like the wife of Toby Plumlee in North Alabama.

TOBY PLUMLEE: She just turned 40 years old the Friday before she died.

FARMER: As soon as his wife was put on a ventilator in August, Plumlee started pressing her doctors about ECMO. They looked 500 miles around.

PLUMLEE: But the more you researched, the more you start to see just how much of a shortage it really is. And you get to the point - and, I mean, the only thing you can do is just pray for your loved one.

FARMER: Plumlee says his wife made it to sixth in line at a hospital hundreds of miles away. It happened to be the same medical center where Phoua Yang, at the start of this story, was finishing her ECMO marathon. She left with a miracle. The other family was left in mourning.

For NPR news, I'm Blake Farmer in Nashville.

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INSKEEP: The story comes from NPR's partnership with Nashville Public Radio and Kaiser Health News.

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