Buying precious time by giving heart and lungs a break
Extracorporeal life support technology in the Mater’s intensive care unit provides hope when conventional support has reached its limits
Dr Edmund Carton (left), medical director of the Mater hospital ECLS Service, with Paul Lynam who was an ECLS patient (right) and Susanne Lynam (second left) and Liza Hayes, ECLS nurse at the Mater hospital.Photograph: Aidan Crawley
One Sunday last February, Paul Lynam was all set to go to see Ireland and England square up against each other in the rugby. But he never got to the match. Instead, he went from feeling under the weather to developing pneumonia, and within days his organs were failing and he was gravely ill. So ill that he needed to spend weeks in intensive care and months recovering.
Yet today you would never know it. Coffee in hand, the 46 year old looks hale and hearty when we meet at Dublin’s Mater Misericordiae Hospital. It’s a few months since he was here, and the clinical staff are full of smiles to see him looking so well because it’s a vastly different scenario to when they first met.
Lynam’s survival was thanks in no small part to the Mater supporting a technology called extracorporeal life support (ECLS), which takes blood out of the body, replenishes it with oxygen and then pumps it back in.
By taking over from the heart or lungs – or both – it can buy precious time for a patient where conventional support has reached its limits, explains Dr Edmund Carton, medical director of the Mater ECLS service.
“ECLS provides advanced support for patients with severe potentially reversible heart or lung failure who have continued to deteriorate despite optimal conventional support,” he says.
“It’s similar to dialysis, which replaces the kidneys, but this replaces the heart and lungs. A dialysis machine has a blood flow of 100-200 millilitres per minute going round it but the blood flow in the ECLS circuit is up to four to five litres per minute.”
Dr Carton first met Lynam as a patient who had become suddenly and seriously ill.
“I was meant to be going to the rugby game on the Sunday and I felt shivery when I woke up that morning and I thought it was the flu, so I stayed in bed,” recalls Lynam, a business executive who works in Dublin.
The next morning he still felt unwell, and Lynam’s wife, Susanne, insisted that they go to Beaumont Hospital. “We were seen to immediately and I was put on a drip and put into isolation,” he says.
Then things took a turn for the worse, though Lynam has little recollection of it. “They said they were going to sedate me and in my mind I thought yeah in 24 hours it will all be good,” he recalls. “Two weeks later I woke up in the Mater.”
During those two weeks Lynam had been on ECLS. It was a decision that Susanne knew she had to make.
“Walking with Paul on a trolley and following the ambulance from Beaumont to the Mater, then waiting in the canteen for two hours and not knowing how things were going was not the nicest experience,” she says. “But I knew that to avoid long-term problems, this would be the best chance for him.”
In Lynam’s case the conventional supports were at their limits, and ECLS was the next option, explains Dr Carton.