PHOENIX — Phoenix Man Survived COVID-19 First in Arizona Through unusual forms of treatment It is called extracorporeal membrane oxygenation (ECMO) therapy.

Enes Dedic, 53, was on the verge of death on a ventilator until the Honor Health doctor used ECMO as a last resort. Dedic was one of the first US patients with COVID-19 to use therapy to overcome the disease, with about 10 worldwide.

ECMO works by helping to supply oxygen to the blood outside the body, eliminating the need for blood to move from damaged or full lungs. Instead, the tube carries blood from the body to the extracorporeal lung, removing carbon dioxide and adding oxygen. At this point, the artificial heart pumps blood back into the body.

According to Dedic’s doctor, ECMO has a mortality rate of about 40%, which is the last hope treatment of “extraordinarily high for almost all medical procedures.”

Ten days after ECMO’s medical coma, Dedic responded and was immediately able to have a FaceTime with his wife.

“I can’t even express myself,” said his wife, Olivera Dedick. “I were jumping over the roof when they woke him up and heard that he was fine.”

Doctors used therapy as a last resort: “ECMO or death for him”

After returning from an overseas trip, Enes Dedic spent several weeks at home in the Deer Valley area of ​​Phoenix, fighting fever, chills, pain and nausea.

He first checked in to the Deer Valley Medical Center in Honor Health on March 15 and quickly deteriorated. He was intubated and transferred to the Honor Health John C. Lincoln Medical Center in Phoenix to enhance mechanical ventilation.

The team of doctors tried everything to save him, said Dr. Anselmo Garcia, a pulmonologist and emergency medical doctor. Enes Dedic was treated with all the drugs that could be used for COVID-19, including hydrochloroquine, azithromycin, Kaletra, Actemra, antibiotics, and anti-inflammatory agents.

None of these worked.

Dr. Robert Reilly of Cardiothoracic Surgery at Honor Health said doctors turned to ECMO as a last resort. Riley performed ECMO surgery.

“At that point it was either ECMO or his death,” said Dr. Ace Oville, a trauma and clinician. “ECMO is a dangerous procedure and there are some associated potential risks, but we felt we needed to give him the opportunity to fight to survive his illness.”

This procedure allowed Enes Dedic’s lungs to rest while the machine was functioning.

Riley said it’s unclear if this would work. At the beginning of COVID-19, early evidence suggested that ECMO is not a useful treatment and its complications outweigh the potential benefits. However, given the criticality of this patient, the benefits are worth the risk, Riley said.

“At the bottom of my heart I thought he was a strong man, he will survive,” Oliveira Dedich said. I have to do all that medicine for him. I was very scared of what would happen. “

Enes Dedic was evaluated daily for oxygen levels, X-rays, laboratory values ​​and organ damage. Garcia said he is steadily improving every day.

Ten days after the coma being treated with ECMO, the doctor woke him up and immediately responded.

“This was a complete team effort,” Garcia said. “A 24-hour nurse, a pulmonologist, and an aide help even housekeeping, and we’re doing everything so that one patient can get the treatment he needs on a daily basis.”

According to Olivera Deditch, he has recently felt “much better,” but still “very weak.” He is doing physiotherapy and is standing next to his bed and working. He is still in the hospital and she does not know when he will be released.

Olivera Dedic hasn’t seen her husband in a month. While he was in a coma she was unable to sleep, cried frequently and worked hard to remember a happy time together. She felt the “50/50” he would survive ECMO treatment.

“It was very emotional and terrifying. I am very grateful to the doctors and nurses and all the hospital staff who saved my husband. I am still Enes De Dick’s wife.”

Is ECMO widely used to treat coronaviruses?

ECMO has been used for many years in patients with H1N1, influenza, and lung injury, Oville said. But it is both a resource- and labor-intensive treatment and a scarce resource.

For every 50-100 ventilators, only one ECMO machine is available, according to Riley. There are five in Honor Health’s system. If the treatment continues to be successful for other important COVID-19 patients, there may not be enough devices to support all the patients in need.

Most patients with COVID-19 can be supported by a ventilator, but some patients become so ill that the ventilator is no longer useful. ECMO is most useful for patients of that type, Ovil said.

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Last week, the Food and Drug Administration issued guidance to extend the availability of ECMO devices to help address COVID-19.

Garcia said the team has been contacted by medical centers across the country for advice. Riley hopes that examples of “out-of-the-box care” will lead to an increase in COVID-19 survivors.

“Proof of concept is very important,” said Riley. “In the beginning we couldn’t even try this and people were dying. Now with some success, we have learned so much about how patients respond from this first patient, and Is being used to treat the next patient. ”

Follow Allison Steinbach on Twitter: @alisteinbach

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