ECMO machines have been around for more than 50 years. For much of that time, they were used primarily to help patients survive while they waited for an organ transplant. But in the last 10-15 years, and especially since Covid, they are being used as a last-ditch effort to stabilize patients whose lungs or hearts are failing.<\/p>\n
The UW Medical Centers at Montlake and Harborview have been on the forefront of this expansion. The two hospitals went from having three ECMO machines in 2012 to 13 in 2025. Last year, they used the machines on 130 patients total, 65 of whom survived.<\/p>\n
UW Medicine also has mobile ECMO teams, like the one that helped Kelli Gehrke, that can be deployed throughout the Pacific Northwest for patients who are too medically unstable to transport.<\/p>\n
Around 50% of patients who are put on an ECMO survive. But that coin-toss survival rate is deceptive.<\/p>\n
For people with lung failure, the survival rate is closer to 70%. The survival rate for people like Kelli Gehrke who are in cardiac arrest is closer to 30%. But the survival rate without the machine for those patients is nearly zero, said Dr. John Scott, a trauma surgeon at the UW Medicine Department of Surgery and the medical director of Harborview\u2019s ECMO program.<\/p>\n
\u201cPatients are not statistics,\u201d Scott said. \u201cFor that patient who is clearly on the verge of death, and you put them on [an] ECMO, and they walk out of the hospital, that changes your whole career.\u201d<\/p>\n
Buying time<\/p>\n
One of the key medical takeaways from the pandemic was the limitations of widely available emergency measures to successfully treat acute respiratory distress syndrome (ARDS). For thousands of Covid patients, the only immediate option was intubation, but that carries risks of infection and other complications.<\/p>\n
\u201cIt’s basically a plastic tube highway for bacteria to enter the lungs and get them re-infected,\u201d said Dr. Jenelle Badulak, associate director of the UW Medicine ECMO program.<\/p>\n
During the pandemic, hospitals and doctors became experts in treating lung failure, and they recognized the value of having ECMO machines to bypass the lungs as a last resort.<\/p>\n
There are two types of ECMO machines \u2014 one that bypasses the lungs only and oxygenates the blood while the patient\u2019s heart continues to pump and a second machine that takes over both heart and lung function.<\/p>\n
\u201cCovid was a crash course in treating ARDS,\u201d Scott said. \u201cA lot of hospitals became a respiratory failure unit overnight. As a result, when we get these calls, so many places have been doing all the hard work. They\u2019ve been doing all the right things, and the patients just aren\u2019t responding.\u201d<\/p>\n
<\/p>\n <\/a><\/p>\n That was the case with 20-year-old Ethan Noack, a junior studying computer engineering at the University of Washington in Tacoma. Noack started having trouble breathing several days after he had surgery to repair torn ligaments in his wrist.<\/p>\n His mother Elaine Martins Noack took him to the emergency room where X-rays showed damage to his lungs that was inconsistent with a healthy teenager with no history of respiratory disease. Ethan Noack was moved to Tacoma General Hospital, but his lungs kept getting worse and his doctors couldn\u2019t figure out why. After a week, he was intubated and airlifted to Harborview, where he was put on a lung-bypassing ECMO.<\/p>\n Shortly after his arrival in Seattle, one of the Harborview residents forwarded an article to Martins Noack about a rare reaction to the antibiotic Bactrim, a drug that her son had been on before and after his wrist surgery.<\/p>\n \u201cAs I read the article, I was first terrified because that child has suffered so much,\u201d she said. \u201cThere was something in me that told me that\u2019s why he was sick.\u201d<\/p>\n When doctors biopsied Noack\u2019s lungs, they confirmed that he was one of only a few dozen verified cases of people who suffered severe ARDS after taking Bactrim.<\/p>\n Dr. Scott said an ECMO buys time for medical staff to evaluate and diagnose challenging cases like Noack\u2019s and gives the body time to do what it does best \u2014 heal itself.<\/p>\n \u201cECMO doesn’t cure the lungs,\u201d he said. \u201cECMO rests the lungs and makes sure the body gets the oxygen it needs while the lungs can recover on their own.\u201d<\/p>\n Air hunger<\/p>\n Noack, who was on an ECMO for more than a month, was determined to become Harborview\u2019s first patient to walk while hooked up to the machine. He said his primary inspiration was the music of Kendrick Lamar.<\/p>\n The staff created a playlist to help get Noack motivated. His mother said it took 10 people to get him walking. They turned the music up extra loud so it wasn\u2019t drowned out by all the beeping and humming of the machines that were keeping Noack alive.<\/p>\n \u201cEach day was a different song, and each day he would walk a little more,\u201d Martins Noack said.<\/p>\n <\/p>\n <\/a><\/p>\n In addition to these small triumphs, her son also endured anxiety, depression, and fear. One of the most challenging things about being awake on ECMO is a side effect called \u201cair hunger,\u201d an intense feeling of suffocation because the patient is awake but not breathing.<\/p>\n Dr. Badulak said rehab psychologists work with ECMO patients, especially during the first few days, to help them overcome the panic of not being able to fill their lungs with air.<\/p>\n For Martins Noack, the memory of her son struggling to breathe was particularly challenging.<\/p>\n \u201cHe would lose control of his body and believe that he was dying even though I was telling him, \u2018You\u2019re not dying. You\u2019re not drowning,\u2019\u201d she said.<\/p>\n The trauma of what her son has been through has shaken Martins Noack’s confidence, even now that he is back home and recovering.<\/p>\n Every time she gets in a car, she worries about getting in an accident, she said. When she takes Ethan for a checkup, she thinks, \u201cWhat if I get in a wreck and he doesn\u2019t have enough oxygen?\u201d<\/p>\n \u201cJust the fragility of existence is something I think will change anyone,\u201d she said.<\/p>\n Road to recovery<\/p>\n Every successful use of an ECMO is the story of a life saved. But many families who come out on the other side may find their lives turned upside down as they struggle to recover from an emergency that almost killed them.<\/p>\n <\/p>\n <\/a><\/p>\n Kelli Gehrke is relearning to walk. She now has a drop foot from where the ECMO was inserted near her groin. Her kidneys were damaged during her illness. She gets dialysis eight hours a week and might need a kidney transplant.<\/p>\n Ethan Noack remains on oxygen at his home in Lake Tapps, Washington. Doctors determined, at the last possible minute, that he does not require a lung transplant.<\/p>\n But questions remain about whether scar tissue will develop around the small holes in his lungs, which could prevent him from a full recovery and restrict him from eventually doing the things he loves, like playing basketball with his friends.<\/p>\n The financial toll<\/p>\n The cost of an ECMO treatment at UW Medicine is about $13,000 a day, according to spokesperson Susan Gregg. While reimbursement levels vary depending on the patient\u2019s health insurance, they also face the challenge of making ends meet during extended recoveries that can last months or years.<\/p>\n RELATED: Trump might shut down UW\u2019s Primate Research Center. Should he?<\/a><\/p>\n For example, Chris Gehrke has not been able to go back to work as a truck driver because he is taking care of his wife, their new baby, and their two other boys, who are 15 and 12.<\/p>\n The baby, Max, refuses to nap. During his mother\u2019s illness, he bonded with his father\u2019s chest, the only thing that calms him. But at least he\u2019s healthy.<\/p>\n \u201cHe’s good,\u201d Kelli Gehrke said. \u201cI’m the one that took the hit, but I’ll take it as long as he’s OK.\u201d<\/p>\n <\/p>\n <\/a><\/p>\n As for Ethan Noack, he\u2019s happy to be back home with his dogs \u2014 Gigi, a shiatsu, Bruno, a corgi, and Sebastian or Seba, the wiener dog.<\/p>\n Friends of the Noack<\/a> and Gehrke<\/a> families have set up GoFundMe pages to help cover the costs of their ongoing health crises and recovery process.<\/p>\n Making the call<\/p>\n Both Scott and Badulak are part of a specialized medical team that decides whether patients would benefit from an ECMO.<\/p>\n The group considers multiple factors in making what is often a life-or-death decision. Do the benefits of the ECMO outweigh the risks? Is the patient\u2019s illness related to their lungs or heart or are they in danger because of something else, such as liver failure, which an ECMO can\u2019t help? What\u2019s the likelihood the person would survive attachment to an ECMO? What would their quality of life be if they did survive?<\/p>\n![\"caption:](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/10\/caaa46d06fdfdd0a1042e82d0ece9b82.jpg\"\/)
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