Patient Suffering from Massive Pulmonary Embolism Saved with Use of ECMO

One day in January of 2022, Jimisha Sailes began hyperventilating and passed out. She was rushed to University Hospitals (UH) Cleveland Medical Center where Dr. Jun Li, a cardiologist with UH Harrington Heart & Vascular Institute, began investigating the cause of her concerning symptoms.

“We knew Jimisha had recently been treated for a blood clot in her neck area, but until now had been doing well and tolerating the medications prescribed. We performed a CT and found clots in both of her lungs,” said Dr. Li. “Jimisha was experiencing a massive pulmonary embolism.”

A massive pulmonary embolism (PE) happens when someone is experiencing heart and lung failure because of a large blockage in the lung arteries, with significant compromise of their blood pressures and oxygenation. About one-third of people with undiagnosed and untreated pulmonary embolism do not survive. This was particularly concerning as Jimisha was just 28 years old and the mother of a young daughter.

“Massive PE is rare and it’s especially rare in someone Jimisha’s age,” said Dr. Li.

General guidelines encourage doctors to treat massive PE with tissue plasminogen activators (tPA), which act as clot busters, but it’s an approach that can generate a lot of bleeding.

In recent years, there has been a shift to treating these types of patients with extracorporeal membrane oxygenation (ECMO), also called a heart-lung machine. ECMO provides heart and lung bypass support outside of someone’s body. Essentially, the machine is doing the work of both the heart and lungs. It was developed in the 1950’s and more widely implemented in the 1970’s, but traditionally was never used for PE patients.

“At UH Harrington Heart & Vascular Institute, we’re always looking to implement innovative treatments and therapies,” said Dr. Li. “We began using ECMO for massive PE patients in 2018 and we’ve had a lot of success. It allows the heart and lungs to rest while we go in and remove the clots.”

Jimisha’s care team placed her on ECMO, stabilized her, and removed her blood blots.

“Implementing ECMO in these cases has helped to save many lives, and it contributed to Jimisha’s positive outcome,” said Dr. Li. “It took just one day to wean her off of ECMO and she was completely extubated within a few days. That’s relatively quick for these types of patients.”

“I remember waking up and being very confused. I didn’t know where I was or what day it was. A doctor told me my heart was in bad shape. I didn’t know I had any heart problems,” said Jimisha. It had been five days since she was placed in a coma and on the ECMO machine.

In the days and weeks after her health scare, Jimisha struggled with memory issues, anxiety and some pain in her legs, but as time moves on she continues to improve. She’s back to caring for her 4-year-old daughter and working from home as a medical records specialist.

“Most of the time, I feel very blessed to still be here for sure. I still wonder why, why this happened. Obviously, there’s a purpose for me to still be here,” said Jimisha.

Jimisha says she has a family history of blood clots. Doctors think her clotting issues could be related to recurrent neck infections, although they’re still looking into the exact cause. Her doctors continue to monitor her condition.

“Life is extremely short. You really don’t know what day might be your last,” said Jimisha. “I had plans for the day I collapsed, for the week that followed. I try not to scare myself thinking about it, but it’s scary what could have happened. I’m definitely grateful to be here, to be here with my family, to be here to raise my daughter.”