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Wilford Hall team transports critically ill infants across the Pacific

  • Published
  • By Linda Frost
  • 59th Medical Wing
LACKLAND AIR FORCE BASE,Texas --  A team from Wilford Hall Medical Center, Lackland Air Force Base, Texas, rushed to Okinawa, Japan, May 24 to save the lives of  two critically ill babies.

The infants, one 9-months-old and the other 20-days-old, were moved from Kadena Air Base, Japan, to San Antonio, Texas, May 26 aboard a C-17 Globemaster III. Both are military dependents needing specialized care at medical facilities in the United States and are currently in stable condition.

The 9-month-old was suffering from congestive heart and severe lung failure at the U.S. Naval Hospital in Okinawa. Despite the efforts of the medical team there, the infant required transfer to the U.S. for immediate and long-term cardiac care.

Doctors felt the child needed to be placed on extracorporeal membrane oxygenation, or ECMO, to survive. 

Wilford Hall is the only medical center in the world with this type of specialized team capable of transporting ECMO patients, whether Department of Defense, civilians or in support of humanitarian missions.

The oxygenation machine provides cardiac and respiratory support to patients whose heart and lungs are so severely diseased or damaged they can no longer serve their function.

The 20-day-old pre-mature infant with respiratory distress was also moved on the same aircraft and cared for by an Air Force neonatal intensive care team.

According to Lt. Col. (Dr.) Daniel Dirnberger, 59th Medical Wing Neonatal Intensive Care Unit director, the 9-month-old was not making any progress with conventional medical and ventilator therapy and needed immediate evacuation to the U.S. for life-sustaining open heart surgery. However, the baby was too unstable to be transported without a heart-lung bypass.

"This was a massive undertaking requiring complex coordination across multiple agencies throughout the Air Force, including personnel at Scott and Hickam Air Force Bases, Kadena Air Base, U.S. Naval Hospital in Okinawa, Tripler Army Medical Center and Wilford Hall Medical Center," said Dr. Dirnberger.

The center's ECMO team traveled to Okinawa May 24, placed the first baby on ECMO and delivered the child 26 hours later to Christus Santa Rosa Hospital in San Antonio with no complications. The second infant, with respiratory distress, had some instability during transport, but physicians say this is not uncommon for a baby that age.

The ECMO team included two neonatologists, two neonatology fellows, a pediatric intensivist, pediatric cardiologist, a team of neonatal and pediatric intensive care nurses, medical technicians and respiratory technicians. 

Because the WHMC pediatric surgeon is just returning from deployment, an Army pediatric surgeon was flown from Tripler Army Medical Center in Honolulu to meet the ECMO team in Okinawa to perform the surgery necessary to place the infant on ECMO.

"I'm extremely proud of our entire team. From technician through physician, every member gave 200 percent of themselves to this mission," said Dr. Dirnberger.

Meantime, there were challenges in getting both children to the states. 

The C-17 had mechanical problems before take off, while the two critically ill infants were waiting for transport.

The clock was ticking fast while a new aircraft was quickly reallocated to assume the medical mission. As ground and aircrews worked feverishly, the ECMO and neonatal transport teams were running out of medical air and electrical power. The infants were taken to the Kadena Air Base Clinic, where they were able to utilize oxygen, medical air and electricity while they awaited departure.

Once the aircraft was loaded, the doctors, nurses and technicians rotated three shifts to ensure that fresh eyes and alert minds were on the patients at all times. 

An in-air refueling mission performed by the 168th Air Refueling Wing, Eielson Air Force Base, Alaska, significantly reduced the trans-oceanic transport time to 14 hours, reducing the total flight time by four to five hours.

"Our ability to support our military dependents overseas with such phenomenal medical and surgical capability reflects a dedication to our families that is unparalleled in the world," Dr. Dirnberger said. "The coordination across multiple military agencies, and the logistical and medical complexities accomplished to bring these babies safely home is a testament to the quality and character of our military healthcare system and the people in it," he said.

The 9-month-old was successfully taken off ECMO at Christa Santa Rosa Hospital and is scheduled for corrective open heart surgery next week. Doctor's expect the child to make a full recovery.

The 20-day-old baby did not require ECMO and is currently under the care of a NICU team at WHMC.