ECMO

atsJournals_logoThe Medical ECMO Program at NewYork-Presbyterian/Columbia University Medical Center recently published two papers in the August volume of Annals of the American Thoracic Society.  The hospital was also featured on the cover of the journal.   One paper focuses on the program’s successful use of extracorporeal membrane oxygenation (ECMO) support in a pilot study for patients with severe exacerbations of COPD with respiratory failure.  The other paper discusses emerging indications for the use of ECMO, such as moderate ARDS and as a destination therapy for patients with chronic lung disease.

Extracorporeal membrane oxygenation (ECMO) is one of several terms used to describe a circuit outside the body (“extracorporeal”) that directly oxygenates and removes carbon dioxide from the blood. ECMO functions as an artificial lung working in addition to the patient’s own failing lungs.

Please follow the links below to access links to both papers and a podcast featuring Dr. Darryl Abrams, Medical ECMO Program Attending, discussing these papers.

To learn more about the Medical ECMO Program at NewYork-Presbyterian/Columbia University Medical Center, please visit us at columbiasurgery.org/ecmo

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Jeffrey Javidfar, MD

Jeffrey Javidfar, MD

Jeffrey Javidfar, MD is a recently graduated member of the 2013 class at Columbia University Medical School’s Surgical Residency Program. Dr. Javidfar began his studies here in 2007, and is currently pursuing a fellowship in cardiothoracic surgery at Duke University. Before he left we caught up with him to learn more about his experience here at Columbia.

Q: How long have you been a resident at Columbia? What has been the focus of your residency?

Jeffrey Javidfar, MD: I began my training as a categorical in Columbia University Medical Center’s General Surgery Residency Program in 2007. I studied all aspects of general surgery. As part of this training, I helped perform surgical procedures and participated in the care of patients with a variety of diseases. In addition to bread and butter general surgery, I rotated through vascular, pediatrics, transplant and cardiothoracic surgery services. I found the thoracic service was particularly interesting and I did a year of research in the thoracic surgery lab between my 3rd and 4th clinical years. The research involved all aspects of thoracic surgery, including lung and esophageal cancer, mediastinal diseases, lung transplantation, and ECMO.

Q: What are your plans once you graduate? Are you continuing your studies in cardiothoracic surgery?

Dr. Javidfar: After graduation I am doing a fellowship at Duke University Medical Center in cardiothoracic surgery, and my focus will be in general thoracic surgery as well as lung transplantation. My hope going forward is to focus my career on thoracic surgery and also continue to work with end stage lung disease and ECMO. Extracorporeal Membrane Oxygenation (ECMO) essentially involves a machine that acts as artificial lungs. It is used for patients who are very sick and having difficulty exchanging air on a mechanical ventilator. It gives their lungs time to recover and heal from acute respiratory failure or can be used to bridge a patient awaiting lung transplantation.

Q: You did a lot of work with ECMO during your time at Columbia. How was that experience?

Dr. Javidfar: I was fortunate to arrive at Columbia just as the ECMO program was picking up, and I did a lot of work with Drs. Matthew Bacchetta and Joshua Sonett on the adult ECMO projects. They have laid the foundation for a thriving adult ECMO program and, along with the pulmonary and medical ICU teams, deserve a lot of the credit.

We are now one of the busiest, if not the busiest, adult ECMO programs in the U.S. and we have done collaborations with major ECMO centers in Europe. The people at Columbia have worked very hard and have made significant advances in the field of ECMO. I hope to continue this work moving forward in my career.

Q: Is it tough as a resident to go into a relatively new field such as ECMO?

Dr. Javidfar: It was tough, but also really exciting. When I began, ECMO was really taking off at Columbia, and I actually had the opportunity to author a majority of the adult ECMO papers coming out of our program in the past few years. So I was able to get a lot of great experience and I have seen the program grow into what it is today.

Q: What will you miss most about your residency? 

Dr. Javidfar: What I will miss most are my fellow residents and the faculty here at Columbia. The faculty is great at taking care of patients, but they also have a natural desire to be invested in resident education. This desire to educate trickles down from the faculty to the senior residents, who pass it along to their junior residents.

Q: What kept your energy and enthusiasm going throughout the program? How do you approach work-life balance as a resident surgeon?

Dr. Javidfar: It can be very tiring sometimes, especially because in addition to the medical side there is a scholarly side that needs to be taken care of when you get home. You need to find one or two things in your life that are important and spend time on those. For me it was friends and family, so I made it a priority to spend time with them. Luckily, my family and friends were very understanding of my situation.

But to see the enthusiasm around you everyday really helps. Everybody here is enjoying themselves and happy to go to work. The strength of the program is the people, the faculty, and the support staff, and that is why a lot of residents stay and become faculty here at Columbia.

Q: What advice would you give to a new resident?

 Dr. Javidfar: I would advise new residents to approach this experience with an open mind and soak up as much knowledge as possible. It is a challenge, but there are so many opportunities and you are only limited by your own ability to take advantage of them. As long as you can do the work and handle the challenge, the faculty is always willing to help and get you involved. You just need to show interest and be tireless.

Q: Is there anything else you would like to say about your time here at Columbia?

 Dr. Javidfar: I had a great experience here. Columbia is in the unique position of having so many surgeons who are at the top of their fields in various specialties, and this really helps the residents. I appreciated the opportunity and getting to take full advantage of that.

Be sure to also stay tuned for the next article in this interview series:
Spotlight on Graduating Chief Resident Dr. Lisa Cannon

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Kevin Rogers Golf Outing & Dinner to Support the ECMO Team

May 6, 2013

TweetLast May, Kevin Rogers, a previously healthy 25 year-old, developed a life-threatening pneumonia that progressed to the point where his lungs and other organs completely failed.  His pneumonia was so severe and his oxygen level so low that even a mechanical ventilator and other intensive treatments could not keep him alive – Kevin was dying.  […]

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ECMO Video: Against All Odds, Mother and Baby Thriving after Life-Threatening Complications

February 7, 2013

TweetWe dare you to not cry. This inspiring video recounts the story of Elizabeth Asher, who almost lost her life, and that of her prematurely born son, Leo, after she developed life-threatening complications while 22 weeks pregnant. Although all of her vital organs shut down and she was bleeding profusely throughout her body, Lizzie survived […]

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BlogTalkRadio: ECMO Advances Clinical Care Practice

January 30, 2013

TweetHave you ever wished you could sit down and freely talk with an expert about a particular health condition or treatment that you or a loved one may be facing? Columbia Surgery is giving you the next best thing – BlogTalkRadio shows featuring experts in every surgical specialty, available to answer questions by listeners like […]

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Fighting for Their Lives

January 18, 2013

TweetFor Daniel Ezra, March 3, 2012 suddenly turned from a tender night of sharing with his pregnant wife how much they loved each other to every husband and expectant father’s worst nightmare. It started when his wife, Elizabeth, who was five and a half months pregnant with their first child, began spotting. “My pregnancy had […]

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ECMO Advances Critical Care Practice at the Center for Acute Respiratory Failure

December 18, 2012

TweetHundreds of thousands of patients suffer from respiratory failure each year. Some of these patients develop such severe conditions that they require treatment in an ICU or require lung transplantation. In order to help patients breathe while critically ill or awaiting lung transplantation, a ventilator is often needed. However, ventilators can further damage already injured […]

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Breathing Easy: How One Woman Got Back Her Future

June 13, 2012

TweetNell Pritchard looks like a normal, healthy young woman as she walks her dog, hangs out with her boyfriend, or goes to the gym. The other day, she played tennis with her sister. She’s 21 years old, 5’4” tall, and weighs 120 pounds—which, for Nell, is a miracle. A few months ago, she was down […]

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Medical ECMO Program Has New Home Online

April 19, 2012

TweetMatthew Bacchetta, MD and Daniel Brodie, MD, Co-directors of the ECMO program at NewYork Presbyterian/Columbia University Medical Center, are pleased to announce a new section on the Columbia website dedicated to this life-saving effort. The Medical ECMO Program is part of the Center for Acute Respiratory Failure, which treats patients who rapidly develop respiratory failure […]

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What is Acute Respiratory Distress Syndrome?

February 6, 2012

TweetWe all know what it’s like to bump an elbow or jam a finger and watch it swell up like rising dough. This swelling, due to increased fluid in the injured tissue, is part of the body’s attempt to promote healing. However, when it occurs in the lungs, it can have dangerous consequences. Acute respiratory […]

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