Mayo Clinic is using heart surgery equipment to save cardiac arrest patients

ROCHESTER – Mayo Clinic doctors here might try to save you from a cardiac arrest by sticking large tubes in your groin.

Those tubes, along with wiring and needles, are connected to an extracorporeal membrane oxygenation (ECMO) machine. ECMO machines have been used in heart surgeries for decades by pumping oxygen and blood through the body — in essence, taking over the role your heart plays through arteries in your legs.

Mayo Clinic plans to expand its ECMO use to treat more patients suffering from cardiac arrest as emerging research shows it could save more lives than previously thought.

Mayo will shift its protocols later this month to treat emergency room patients who experience arrest throughout Rochester and anywhere within 30 minutes of St. Marys Hospital.

"This is one of the newer technological steps that we have had ... in a long time," said Suraj Yalamuri, an anesthesiologist and intensivist at Mayo Clinic. "It's nice to be able to expand the role of who this is being offered to."

Mayo officials say Rochester is among a handful of communities in the U.S. treating cardiac arrest patients with ECMO devices, though Minnesota is leading the charge. The University of Minnesota Medical School equipped a mobile ECMO truck in 2021 to serve patients in the southwest metro area.

The shift comes as there is growing awareness about cardiac arrest — which happens when your heart suddenly stops beating, rather than a blockage that causes heart attacks — in the wake of Buffalo Bills defensive back Damar Hamlin's cardiac arrest during an NFL game in Ohio last month.

Hospital systems have been reluctant to use ECMO in treating cardiac arrest in the past because there wasn't enough data supporting the idea, according to Dr. Ashish Panchal of The Ohio State University Wexner Medical Center.

Panchal, an emergency medicine specialist, chairs the American Heart Association's (AHA) emergency cardiovascular care subcommittee and helped author the association's recommendations on ECMO in 2020. The AHA was cautious at the time, in part because few hospitals had the teams and equipment in place to make this type of treatment routine.

"It has amazing potential, but still we need more data to figure out what that potentially looks like," Panchal said.

A 2020 U of M report shows cardiac arrest patients treated with ECMO are six times more likely to survive than patients treated with the standard mix of CPR, defibrillation and medication — from about an 8% chance of survival up to 48%. Other studies done in recent years show similar results, prompting Mayo doctors to rethink how they treat cardiac arrest patients.

ECMO machines are typically the last line of defense for patients suffering heart or lung issues. They were crucial for COVID-19 patients over the past few years, but any type of patient has little better than 50-50 odds of surviving after being placed on an ECMO machine, according to an international database.

In fact, an ECMO machine could make things worse for some patients who suffer cardiac arrest.

"It's better to do what you can, but identifying that small group of patients who will benefit from ECMO is the key," said Anuradha Luke, a medical director at Mayo Clinic.

Mayo Clinic paramedics have trained with first responders at the Rochester Fire Department in recent months to identify who qualifies for ECMO treatment, which nationally ends up being about 2% to 3% of people experiencing cardiac arrest.

Patients typically have to be adults up to age 65. Someone has to witness the patient's cardiac arrest. CPR must be delivered prior to first responders arriving, defibrillators have to pick up an irregular heart rhythm and the patient needs to be within 30 minutes of the hospital.

Mayo staff drilled the new procedure on Monday morning, combining paramedics with an emergency room crew and cardiac specialists to connect a dummy simulating a cardiac arrest patient to an ECMO machine. Dr. Alexander Finch, an emergency medicine specialist and instructor at Mayo Clinic, said Mayo has drilled at least once a quarter for the past year and a half in preparation for treating more cardiac arrest patients with ECMO machines.

On Monday, it took staff seven minutes to hook the dummy to the machine, even as doctors in the room said it could take 20 or more minutes with actual patients.

"We're bringing an entirely new team in to a relatively small space and we all have to work for the same goal," Finch said. "We practice over and over to make that handoff perfect."