Hartford Hospital team flies to the aid of CT’s sickest patients

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By Liese Klein

Category: Corporate Achievement — Innovation

Hartford Hospital’s Extracorporeal Membrane Oxygenation or ECMO Team, led by Dr. Jason Gluck

Lying in the cath lab of a community hospital, the patient didn’t stand much of a chance. He had suffered a major heart attack while working out at the gym and he remained in severe shock, his heart too weak to keep him alive for long.

The patient desperately needed treatment at a major heart center but he was too sick to be moved.

Enter Hartford Hospital’s three-person ECMO team, flying in by helicopter to offer lifesaving treatment. Led by Dr. Jason Gluck, the specialized trio hooked the patient up to devices that temporarily took the place of both his heart and lungs — pumping blood, supplying oxygen to the blood and removing carbon dioxide. Once stabilized, the patient was transported to Hartford Hospital, where he eventually received a heart transplant. He is now recovering at home and has become an advocate for requiring defibrillators in every gym in the state.

“That’s an example of how the program works,” Gluck said, describing the “ECMO on the Go” team that he has pioneered at Hartford Hospital. ECMO, or extracorporeal membrane oxygenation, is a once-obsolete treatment that has been retooled in recent years to help the sickest patients suffering heart and lung failure. Using cutting-edge techniques, trained experts and revamped devices, Gluck’s team has mobilized ECMO and the state’s emergency transport system for use around Connecticut.

“It’s too hard for every hospital to have this technology because the techniques and management are challenging,” Gluck said. “[ECMO on the Go] is a real good solution for a hospital that doesn’t have the technology, to call us in and we can help.”

Since the mobile ECMO team’s creation in 2013, 53 patients across the region have been treated and transported for further care to Hartford Hospital. In a field where a 50-percent survival rate indicates a “top-tier” program, Hartford Hospital’s mobile ECMO program boasts a 67-percent survival rate.

Gluck’s unusual background plays a key role in the success of the ECMO team, colleagues said. The son of a “pool guy” on Long Island, Gluck grew up fascinated by the mechanics of pumps, which initially led him to a career as a New York City firefighter. He then enrolled in medical school and was drawn to the field of cardiology upon his graduation in 2003. The human heart is basically a pump “not so different from fire pumps,” he said.

His background as a first responder led Gluck to explore the potential of the retooled ECMO technology as soon as he joined Hartford Hospital in 2010 as director of mechanical circulatory support and emergency cardiac care. He looked to Europe and the military, which uses ECMO in the field to save lives.

“There are lots of reasons why this technology can be employed,” Gluck said. “Why can’t we do it here in Connecticut?”

The size of a small suitcase, the hardware behind ECMO consists of a compact pump, oxygenator and tubing, connected to the patient through a cannula, or thin tube inserted into a blood vessel. The mobile ECMO team is made up of a cardiologist, surgeon and perfusionist, or specialist in heart-lung machines.

“[ECMO] can provide very robust support; it can eventually take over for both the heart and lungs, allowing the body to recover,” Gluck said. Improved pump design and better techniques have made the technology more versatile in the last decade, he added. Tinkering in his garage, Gluck also crafted a simulator to allow for advanced training with the ECMO devices at Hartford Hospital.

Beyond the technical and training challenges of ECMO, Gluck has also had to coordinate response with medical transport teams and health centers across the region.

“He has created this network with the EMS system, Life Star and other hospitals to help people who otherwise might not make it,” said David Rosinski, director of cardiovascular perfusion at UConn Health, Connecticut Children’s Medical Center and Waterbury Hospital. “He’s done it and it’s really impressive. It’s pioneering for our area.”

Gluck has also become a national and international leader in advocating for the expanded use of ECMO to save lives.

“He’s a young, charismatic leader in the field,” Rosinski said. “He’s taken it to a whole different level.”

With flu season underway, Gluck said that ECMO should be on the minds of all caregivers and those at risk from the virus.

“Anybody whose loved one has a severe case of flu really should be asking their doctor, ‘Is my loved one a candidate for ECMO?” Gluck said. “There’s often times an opportunity for us to come help.”

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