The use of a life saving by-pass machine has reached a 30-year milestone in Aotearoa New Zealand.
A dedicated "ECMO Centre" is now well established at Auckland Hospital.
It specialises in providing "last resort" heart and lung by-pass treatment to about 25 gravely ill patients a year.
It’s a far cry from 1993 when the country’s very first ECMO machine was hurriedly put together by experts in cardiac care at Greenlane Hospital in Auckland.
The experts had decided an ECMO (extracorporeal membrane oxygenation) machine was only option available to save the life of the then 13-year-old Laurence Koelmeyer. The young teen had barely survived a 20 metre fall through a carpark skylight on Princes Wharf in downtown Auckland.
“He was critically unwell,” said nurse Nic Gini who cared for Laurence all those years ago. “And it was at that point where they'd run out of options to be able to actually, you know, keep him alive.”
Gini remained involved in the treatment and was now the ECMO co-ordinator at Starship Hospital.
"So the decision was made,” she said, “There was nothing to lose trying to put the machine together.”
Gini recalled ECMO treatment had been tried in New Zealand but was no longer practiced and no machine was available.
"The profusion team which looks after the heart lung machines and anaesthetists knew of ECMO," she said. "It had been used overseas and been tried previously in New Zealand quite some time ago."
So the specialists got together and began assembling a "makeshift" machine from equipment at Greenlane Hospital.
Teenager Laurence Koelmeyer was sedated and unaware of the efforts being made to save his life.
"The day of the fall, I have no memories of what happened," the now 43-year-old said. "It would have been several weeks after the event I’d say because I was in a coma for three weeks. I sort of have this recollection of waking up in a hospital bed and sort of pinching myself and thinking is this real?"
Gini remembers a very tense first 36 hours when Laurence was connected to ECMO machine assembled by the team at Greenlane Hospital. She said team members never left his bedside.
"There's lots and lots of risks," she said. "When you go on an ECMO machine you've got to have an almost 80% chance of death without it because of the risk of complications."
Laurence’s family were so concerned they asked a priest to perform the Last Rites.
"I can only imagine what my family went through was quite devastating. They’ve got a lot more memories than I do," Koelmeyer said.
"It would have affected them differently. I’ve been through the recovery phase and not really the grieving side of it."
The heart lung bypass machine gave the patients' damaged organs the chance to recover enough to start functioning independently.
Gini said no one on the medical team knew how Laurence would respond.
"I think it was a 50/50 toss of a coin to be honest," she said.
"It was unknown with the injuries he had as to whether or not he'd get complications or whether he'd survive."
But prayers were answered and with months of recovery still ahead – Laurence survived.
"There's something about intensive care nurses," Gini said.
"We love technology. We love seeing patients going from being unwell to doing fantastically. You can't beat that."
As for Laurence Koelmeyer – he remained incredibly grateful.
"If you believe in fate, the stars aligned," he said. "It’s one of those things where everything lined up perfectly."
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