Brooke Army Medical Center Public Affairs
9/18/2013 - JOINT BASE SAN ANTONIO-LACKLAND, Texas -- An ambulance carrying a critically ill newborn sped across town to Wilford Hall Medical Center in San Antonio.
Every second counted as the military doctors raced to save Jacquelyn Burke's life. A neonatal team hooked her up to a heart-lung bypass machine, dubbed ECMO. Jacquelyn's heart and lungs were failing, and the new technology was the only remaining hope to keep her alive long enough for her lungs to recover. As her parents stood by, the doctors and nurses worked for days in the hopes she'd pull through.
Burke not only survived, she thrived. Nearly 30 years later, she's come forward to share her story -- and gratitude -- for those who saved her life back in April 1986.
"I proudly wear the scars on my neck and chest with honor," she wrote in a recent email. Without them ... I would not be here raising my son. I am very blessed and grateful."
ECMO, which stands for extracorporeal membrane oxygenation, is a heart-lung bypass system that circulates blood through an external artificial lung, oxygenates it, then delivers it back into the bloodstream. It does the job of the patient's heart and lungs and gives them time to respond to treatments and heal, explained Air Force Lt. Col. (Dr.) Daniel Dirnberger, chief of neonatal medicine at San Antonio Military Medical Center here.
It's a proven lifesaver for infants with critical issues such as certain congenital defects , pulmonary hypertension, or, as in the case of Burke, meconium aspiration, which is when a baby inhales fetal meconium either before or during birth.
"With ECMO, we are adding a layer of care and allowing babies more time to recover," Dirnberger said. "In many cases, we're turning less than a 20 percent chance of survival into 80 percent."
The timing of Burke's treatment was fortunate. The hospital had stood up its neonatal ECMO program just one year prior, becoming the 12th of its kind in the country.
"It was new technology at that time," Dirnberger noted. Wilford Hall stood up the first ECMO center in Texas in 1985, and it was the only one in San Antonio when Burke was born. Burke, he added, was just the 10th neonatal ECMO patient at Wilford Hall.
In 2011, the program moved to SAMMC as part of the Base Realignment and Closure directive. It remains the sole neonatal ECMO program in the Department of Defense.
Over the years, more neonatal ECMO centers have been established, but the program here remains one of a few ECMO transport centers in the world. The SAMMC team has picked up and transported infants needing ECMO from around the United States and as far as Spain and Japan. The long-range transports are "tremendous endeavors," Dirnberger said, in some cases requiring two shifts of personnel and 2,000 pounds of equipment.
Dirnberger recalled the military's longest-range ECMO transport out of Wilford Hall in 2000. It was his first day as a staff neonatologist in Okinawa when a baby was born with meconium aspiration. The baby's health spiraled down so they requested an ECMO team for transport. The team arrived 36 hours later, placed her on ECMO and flew her back to San Antonio, where she was successfully treated.
That was the first of six ECMO transports out of Okinawa, Dirnberger said, noting that Wilford Hall and SAMMC have executed a total of 81 neonatal and pediatric global ECMO transports since 1985.
"Some of our most memorable ECMO babies were ECMO transports," he said.
As he spoke, Dirnberger pointed to a framed article about the baby from Okinawa hanging in the NICU hallway, which is lined with dozens of plaques and baby pictures. Each of these plaques, donated by grateful parents, tells a story about a baby who was treated at Wilford Hall or SAMMC. Some are adorned with pictures and others with simple words of gratitude. "Thank you for saving our son's life," one plaque reads. "It's amazing how one miracle can touch so many lives."
While these plaques are greatly appreciated, the doctor said, just knowing he had a hand in a baby's recovery is the only thanks he needs.
"This is why I went into neonatal medicine," he said. "To be involved with any lifesaving procedure ... it's tremendously gratifying."
Burke, who now lives in San Antonio with her 7-year-old son, said her aunt reminded her about her ECMO treatment at a recent lunch, and felt compelled to thank the doctors and nurses who saved her life 27 years ago.
"I wouldn't be here if it weren't for them," she said. "I will always be grateful for what they did."
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