PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Washington University surgeons successfully use artificial lung in toddler

2011-06-17
(Press-News.org) Two-year-old Owen Stark came to St. Louis Children's Hospital in the summer of 2010 near death from heart failure and dangerously high blood pressure in his lungs.

Washington University physicians and surgeons at St. Louis Children's Hospital knew they had to act fast to save his life. They collaborated to make several strategic and innovative decisions that led to the first successful use of an artificial lung in a toddler.

Their efforts are reported in the June 2011 issue of The Journal of Thoracic and Cardiovascular Surgery.

The artificial lung, made by Novalung of Germany, "breathes" outside the patient's body to add oxygen and remove carbon dioxide from the blood. It is approved only for adults and has been used to treat severe pulmonary infections or as a bridge to lung transplantation. The lung works without a pump, using the body's natural heartbeat to circulate blood.

Owen was transported to St. Louis Children's Hospital in full heart failure from abnormally high blood pressure in the lung's arteries. In this rare condition, called pulmonary hypertension, blood is prevented from entering the lungs because the arteries are too narrow. This causes the right side of the heart, which pumps blood through the lungs, to work harder than normal and become enlarged, which leads to heart failure.

Avihu Z. Gazit, MD, a Washington University pediatric critical care physician, was the first to treat Owen at St. Louis Children's Hospital. Initial tests showed that the right ventricle of Owen's heart was extremely large, compressing the left side of his heart and creating severe high blood pressure in the lungs, an often fatal condition with no known cause.

Typically, pulmonary hypertension is first treated with medication, Gazit says. However, Owen's condition was so severe that in addition to medication, he was placed on a ventilator in an attempt to force oxygen into his lungs. Physicians thought Owen may eventually need a lung transplant.

"We hoped the ventilator would allow us to get him well enough that he wouldn't need to be put on a heart-lung machine," Gazit says. "But 24 hours later, we knew that wouldn't be the case, and we had to make the decision to go forward with the heart-lung machine called ECMO (extracorporeal membrane oxygenation). We knew that his chances of survival were getting smaller and smaller."

ECMO gives the heart and lungs time to recover and respond to medical treatment prior to a lung transplant. However, it comes with a high rate of complications, including bleeding, blood clots, infection and stroke, and carries a high mortality rate in patients who go on to have a lung transplant. Complications become more severe the longer a patient is on the machine, especially after 10-14 days, Gazit says.

After 16 days on ECMO, Owen's heart had recovered but his lungs had not. Since there were no lungs available for transplant, Owen's physicians knew they didn't have a lot of time. So the team, led by Charles B. Huddleston, MD, professor of surgery and a cardiovascular surgeon at St. Louis Children's Hospital; Stuart C. Sweet, MD, associate professor of pediatrics and a lung transplant surgeon; Gazit; and R. Mark Grady, MD, associate professor of pediatrics and director of the pediatric pulmonary hypertension program, decided to put Owen on the artificial lung, even though it had never been used on a child so young.

After getting emergency approval from the U.S. Food and Drug Administration and from Washington University's Institutional Review Board, Huddleston moved Owen from ECMO to the artificial lung in an innovative procedure without the need for a cardiopulmonary bypass.

The Novalung artificial lung is a small box about the size of a lunchbox that is attached through a shunt created between the main pulmonary artery and the left atrium of the heart.

"This case was very interesting and challenging from a physiological standpoint," Gazit says. "We had to determine what to do with Owen's lungs – do we support him and wait for a lung transplant or do we work to improve the lungs to get him off of the artificial lung? We had to think about this every step of the way to form an approach."

Occasionally Owen had to be taken off of the artificial lung to have parts of the circuit changed. Initially his blood pressure and oxygen levels dropped significantly, but over time, his ability to sustain adequate oxygen levels improved. Another indicator for improvement was the increased blood flow through Owen's lungs rather than through the device.

Owen was on the artificial lung for 23 days when he accidentally kicked off one of the device's connectors. This resulted in Owen having a stroke and required swift action. However, when Owen was taken to the operating room to reconnect the device, Huddleston found that Owen's lungs had healed enough to allow adequate blood flow on their own.

"Owen was able to come off of the artificial lung," Gazit says. "We had no idea that we'd be able to get him off of the device before a transplant. It showed us that everything we did was the right thing."

"It is important to mention that our success is the result of a major collaborative effort," Gazit says. "Owen survived because of the dedication and hard work of our nursing staff, respiratory therapists and perfusionists."

A year later, Owen continues to take medication for pulmonary hypertension and so far has been able to avoid a lung transplant, says Stuart C. Sweet, MD, medical director of the Pediatric Lung Transplant Program at St. Louis Children's Hospital.

This experience with the artificial lung gives the medical community an option to manage young children with similar illnesses and support them prior to a transplant, Gazit says.

"We would like to be a part of or lead a trial," he says. "It requires a multi-institutional effort and we really hope that all of the large lung transplant centers will join us in this effort."

### END


ELSE PRESS RELEASES FROM THIS DATE:

'Ultrawideband' could be future of medical monitoring

2011-06-17
CORVALLIS, Ore. – New research by electrical engineers at Oregon State University has confirmed that an electronic technology called "ultrawideband" could hold part of the solution to an ambitious goal in the future of medicine – health monitoring with sophisticated "body-area networks." Such networks would offer continuous, real-time health diagnosis, experts say, to reduce the onset of degenerative diseases, save lives and cut health care costs. Some remote health monitoring is already available, but the perfection of such systems is still elusive. The ideal device ...

Why disparities in dental care persist for African-Americans even when they have insurance coverage

2011-06-17
African Americans receive poorer dental care than white Americans, even when they have some dental insurance coverage. To better understand why this is so, researchers at Columbia University's Mailman School of Public Health and the College of Dental Medicine, surveyed African American adults with recent oral health symptoms, including toothaches and gum disease. Their findings provide insights into why disparities persist even among those with dental insurance and suggest strategies to removing barriers to dental care. The findings are published online ahead of print ...

Scientists develop a fatty 'kryptonite' to defeat multidrug-resistant 'Super bugs'

2011-06-17
Bethesda, MD— "Super bugs," which can cause wide-spread disease and may be resistant to most, if not all, conventional antibiotics, still have their weaknesses. A team of Canadian scientists discovered that specific mixtures of antimicrobial agents presented in lipid (fatty) mixtures can significantly boost the effectiveness of those agents to kill the resistant bacteria. This discovery was published online in The FASEB Journal (http://www.fasebj.org). According to a researcher involved in the study, Richard Epand, Ph.D. from the Department of Biochemistry and Biomedical ...

The sweet growth of plant cells

2011-06-17
Porto Alegre, Brazil- Glycomics is the functional study of the entire set of sugars found in a given species. To some, the term may sound like a distant cousin of more familiar names such as genomics and proteomics. Indeed, while genomics and proteomics of several species have been extensively investigated in the last years, glycomics is still an emerging field. Now, a paper published in Science magazine by an international collaboration headed by Dr. Jose Estevez (University of Buenos Aires, Argentina) and co-authored by researchers from Argentina, Brazil, Denmark, the ...

EPOXI finds Hartley 2 is a hyperactive comet

EPOXI finds Hartley 2 is a hyperactive comet
2011-06-17
Hartley 2's hyperactive state, as studied by NASA's EPOXI mission, is detailed in a new paper published in this week's issue of the journal Science by an international team of scientists that includes Lucy McFadden of NASA's Goddard Space Flight Center in Greenbelt, Md. After visiting a comet and imaging distant stars for hints of extrasolar planets, you could say the spacecraft used for EPOXI had seen its fair share of celestial wonders. But after about 3.2 billion miles (5.1 billion kilometers) of deep space travel, one final wonder awaited the mission's project and ...

Landsat 5 satellite sees Mississippi River floodwaters lingering

 Landsat 5 satellite sees Mississippi River floodwaters lingering
2011-06-17
In a Landsat 5 satellite image captured June 11, 2011, flooding is still evident both east and west of the Mississippi River near Vicksburg, Miss. Standing water is most apparent, however, in the floodplain between the Yazoo and Mississippi rivers north of Vicksburg. On May 19, 2011, the Mississippi River reached a historic crest at Vicksburg. According to the Advanced Hydrological Prediction Service (AHPS) of the U.S. National Weather Service, the river reached 57.10 feet (17.40 meters) that day. By early June, flooding had receded considerably around Vicksburg, but ...

Firestorm of star birth in the active galaxy Centaurus A

Firestorm of star birth in the active galaxy Centaurus A
2011-06-17
Resembling looming rain clouds on a stormy day, dark lanes of dust crisscross the giant elliptical galaxy Centaurus A. Hubble's panchromatic vision, stretching from ultraviolet through near-infrared wavelengths, reveals the vibrant glow of young, blue star clusters and a glimpse into regions normally obscured by the dust. The warped shape of Centaurus A's disk of gas and dust is evidence for a past collision and merger with another galaxy. The resulting shockwaves cause hydrogen gas clouds to compress, triggering a firestorm of new star formation. These are visible ...

STX Golf Announces its 2011 Club Championship Campaign

2011-06-17
STX Golf, world-renowned as an industry pioneer in putter innovation, and for its patented Soft Face Insert Technology, announced today that their 2011 Club Championship Promotion officially begins the same week as the 111th US Open. As the best golfers from around the world tee it up at Congressional to try and capture the coveted US Open Championship, golfers everywhere will be competing to win their own club championship. According to STX Director of Golf Steve Henneman, "To win a club championship is a real honor. It takes time, practice, and skill to be the ...

Where have all the flowers gone?

Where have all the flowers gone?
2011-06-17
It's summer wildflower season in the Rocky Mountains, a time when high-peaks meadows are dotted with riotous color. But for how long? Once, wildflower season in montane meadow ecosystems extended throughout the summer months. But now scientists have found a fall-off in wildflowers at mid-season. They published their results, funded by the National Science Foundation (NSF), in the current issue of the Journal of Ecology. "Shifts in flowering in mountain meadows could in turn affect the resources available to pollinators like bees," says David Inouye of the University ...

LSU researchers see an indication of a new type of neutrino oscillation at the T2K experiment

2011-06-17
BATON ROUGE – LSU Department of Physics Professors Thomas Kutter and Martin Tzanov, and Professor Emeritus William Metcalf, along with graduate and undergraduate students, have been working for several years on an experiment in Japan called T2K, or Tokai to Kamioka Long Baseline Neutrino Oscillation Experiment, which studies the most elusive of fundamental subatomic particles – the neutrino. The team announced they have an indication of a new type of neutrino transformation or oscillation from a muon neutrino to an electron neutrino. In the T2K experiment in Japan, a ...

LAST 30 PRESS RELEASES:

Study tracks chromium chemistry in irradiated molten salts

Scientists: the beautiful game is a silver bullet for global health

Being physically active, even just a couple of days a week, may be key to better health

High-fat diet promote breast cancer metastasis in animal models

A router for photons

Nurses and AI collaborate to save lives, reduce hospital stays

Multi-resistance in bacteria predicted by AI model

Tinker Tots: A citizen science project to explore ethical dilemmas in embryo selection

Sensing sickness

Cost to build multifamily housing in California more than twice as high as in Texas

Program takes aim at drinking, unsafe sex, and sexual assault on college campuses

Inability to pay for healthcare reaches record high in U.S.

Science ‘storytelling’ urgently needed amid climate and biodiversity crisis

KAIST Develops Retinal Therapy to Restore Lost Vision​

Adipocyte-hepatocyte signaling mechanism uncovered in endoplasmic reticulum stress response

Mammals were adapting from life in the trees to living on the ground before dinosaur-killing asteroid

Low LDL cholesterol levels linked to reduced risk of dementia

Thickening of the eye’s retina associated with greater risk and severity of postoperative delirium in older patients

Almost one in ten people surveyed report having been harmed by the NHS in the last three years

Enhancing light control with complex frequency excitations

New research finds novel drug target for acute myeloid leukemia, bringing hope for cancer patients

New insight into factors associated with a common disease among dogs and humans

Illuminating single atoms for sustainable propylene production

New study finds Rocky Mountain snow contamination

Study examines lactation in critically ill patients

UVA Engineering Dean Jennifer West earns AIMBE’s 2025 Pierre Galletti Award

Doubling down on metasurfaces

New Cedars-Sinai study shows how specialized diet can improve gut disorders

Making moves and hitting the breaks: Owl journeys surprise researchers in western Montana

PKU Scientists simulate the origin and evolution of the North Atlantic Oscillation

[Press-News.org] Washington University surgeons successfully use artificial lung in toddler