November 14, 2008
Team effort truly makes a difference

Although Karla Leavenworth, a 35-year-old mother, struggled with chronic back pain for which she had undergone multiple operations and taken many medications, she otherwise was in excellent health. The medication treatments for her back pain were complicated by the
development of seizures, but these were well-controlled, and she was in good physical shape until one day in October 2007.

At her home in Springfield, Mass., Leavenworth began to experience what would be a prolonged series of seizures. As she continued to seize for nearly two hours despite large doses of anticonvulsant medications at her local hospital, Leavenworth's condition perplexed physicians. When she developed an overwhelming infection and organ failure, doctors made the lifesaving decision to transport her to the Neurocritical Care Unit at the MGH.

Under the direction of Lee H. Schwamm, MD, vice chairman of Neurology, Leavenworth's seizures were quickly and effectively treated, but her lung condition continued to spiral out of control and threatened her life. Schwamm and colleagues had determined that a bacterial infection had invaded both of her lungs and spread to her vital organs. To address this, Schwamm enlisted the help of a multidisciplinary team of intensive care unit consultants from the departments of Medicine, Surgery, Anesthesia, Respiratory Care and Infectious Diseases.

When her body failed to respond to every known medical treatment for the lung injury, Schwamm and his team added David Lawlor, MD, of MassGeneral Hospital for ChildrenÕs Pediatric Surgical Services, to the team. Lawlor agreed that there might be a way to give Leavenworth's body a fighting chance to recover Ð providing cardiac and respiratory support oxygen through extracorporeal
membrane oxygenation (ECMO). The MGHfC is one of only two hospitals in New England to provide this lifesaving treatment, which typically is used to care for newborns lacking a fully functioning respiratory system. ECMO oxygenates and removes carbon dioxide from the patient's blood outside his or her body, allowing the heart and lungs time to strengthen.

"Ms. Leavenworth's pulmonary function had deteriorated to the point where maintaining even unacceptably low blood oxygen levels required unsustainable and harmful ventilator settings," says Lawlor. "Extracorporeal life support was her only option for survival."
"I am certain that with ECMO, Ms. Leavenworth's life was saved," adds Schwamm. "Once the machine took over, her improvement was miraculous. We are so grateful to the pediatric surgery team for being willing to make this bold attempt to save her life."

After ECMO treatment, Leavenworth's condition stabilized, and she gradually improved. She was transferred to the Respiratory Acute Care Unit, where intensive speech, physical, occupational and respiratory therapy enabled her to safely breathe and swallow on her own without the need of a ventilator. 

Today, Leavenworth has nearly fully recovered and continues to work on her recuperation as an outpatient at the MGH. She credits the physicians, nurses, respiratory therapists, ECMO specialists and all of the others who cared for her for saving her life. "If these people hadn't done what they did, I wouldn't be here," she says gratefully. "There were so many people who came into play that I'll never be able to thank personally because I just don't remember them – I was in a coma. But I truly believe that the doctors and nurses and clinicians at Mass General are the best anywhere. They saved my life."

A THANKFUL PATIENT: Leavenworth with her daughter, Taylor, and her mother and father, Janet and Bob Belli


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