'Buying time to live’
Three consultants - Stephen Tricklebank Chris Meadows and Nicholas Ioannou (pictured above) – took part in the St Thomas’ Abseil to raise money for a vital service that has revolutionised critical care services at Guy’s and St Thomas. Chris, Nicholas and Stephen tell us why...
‘Guy’s and St Thomas’ is one of five specialised commissioned ECMO services within the UK. ECMO stands for Extra Corporeal Membrane Oxygenation. It’s a bit like putting a patient on an artificial lung or heart machine. We cover a region of about 17 million people (adults, not children). There are currently seven consultants, soon to be eight, who are intensive care consultants. We are on call 24/7 and 365 days a year.
‘Any of the 42 hospitals in our region can call us and ask for advice about patients with lung or heart failure. If we think it is appropriate, we will go with a team in an ambulance and put the patient on the ECMO system in their hospital’s operating theatre. We will stabilise the patient and bring them back to St Thomas’.
‘It’s often young people we treat, and without this service, their chance of survival is only 10-20%. We convert that into a 75% walk out of hospital rate. ‘Typical patients would be those with influenza or pneumonia, or heart failure caused by a virus, inflammation or infection. These people deteriorate so quickly that within hours they find themselves in intensive care and in trouble. They’ve reached the limits of what we call conventional intensive care and they need the support of specialist intensive care and that’s what we offer.
‘ECMO has been around since the 1970s in North America and it’s been in the UK since the mid-90s but it’s a very specialist service. It has absolutely revolutionised the care of people with complete heart failure or complete lung failure.
‘We have been running this now for five years and it has been hugely successful. Guy’s and St Thomas’ now runs the biggest lung failure ECMO service in Europe. We have about 100 patients a year on ECMO and we’ve grown over the last five years to such an extent that we’ve outgrown our capacity in intensive care.
‘The Trust is now building a brand new intensive care unit which will be an 11 bedded unit on the 6th floor of the East Wing. That will be our new ECMO unit, and it will free up space in the other units that can be used for general intensive care patients.
‘The key thing about the ECMO is that like a lot of supportive care it is supportive therapy. It doesn’t solve the heart or lung problem but it buys us really important time for these young people, who are deteriorating rapidly, to halt many of the processes that contributed to the deterioration. This allows us to find out what the underlying problem is and diagnose it and treat it.
‘What motivated us to take part in the abseil was the fact that we recognise that Guy’s and St Thomas’ needs this capacity. ECMO is working wonders for young people who are at death’s door who are turning around and walking out of hospital. Because we feel so strongly that we need this unit, we are willing to do anything to assist.’