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Technology engineered at ASU 50 years ago helps battle COVID-19

May 13, 2020

Fifty years ago, Arizona State University researchers contributed to the development of medical technology that is now helping a small but growing number of patients recover from COVID-19.

The recovery of a 53-year-old Phoenix man who had been placed in a medically induced coma due to the coronavirus is one example of the benefits of extracorporeal membrane oxygenation, or ECMO, treatment.

The Arizona RepublicABC15 News in Phoenix, The Hill, MedPage Today and other news outlets quoted physicians who attributed the man’s recuperation to ECMO treatment — recently approved by the Food and Drug Administration for COVID-19 patients.  

ECMO technology enables temporary replacement of heart and lung function by pumping blood outside a patient’s body, oxygenating the blood and removing carbon dioxide waste, and then returning it to the patient’s body.

ECMO schematic

The schematics of the extracorporeal membrane oxygenation, or ECMO, technology shows the features of the medical device and depicts the process it performs in taking blood from the body, removing carbon dioxide waste and returning healthy blood to patients. Permission for use granted by Thomas V. Brogan, M.D., senior editor of Extracorporeal Life Support: The ELSO Red Book 5th Edition, 2017

In the late 1960s and early '70s, Arizona State University chemical engineering graduate student Keith Larsen and his mentor, the late William Dorson, helped to significantly advance research in the development of a pediatric membrane oxygenator. They then recorded the earliest attempts to use ECMO support on infants at St. Joseph’s Hospital in Phoenix.

Dorson, a professor of chemical engineering, and Larsen worked together to expand Dorson’s seminal clinical studies. They collaborated with St. Joseph’s Hospital physicians to conduct the first clinical trials of a treatment for infants who had breathing problems stemming from a lung disorder called hyaline membrane disease.

Dorson drew on his groundbreaking research on the development of artificial organs, particularly artificial lungs and kidneys, to introduce how fundamental engineering principles can directly translate into medical innovations in patients, says Vincent Pizziconi, who came to ASU in 1968 as a graduate student, working with Dorson on the design and development of an artificial kidney. Pizziconi is now an associate professor of biomedical engineering and the founder and director of the Bioengineering Design Studio in the Ira A. Fulton Schools of Engineering at ASU.

Dorson developed some of the country’s earliest graduate courses in biomedical engineering with the goal of training engineers to apply engineering principles to address unmet needs in health care, a legacy that continues to this day in the School of Biological and Health Systems Engineering, one of the six Fulton Schools.

“From these early beginnings of ECMO to its now widespread use for infants, children and adults with life-threatening lung and heart problems, to its recent application to patients suffering from COVID-19 who are not responding to ventilators, ECMO has had increasingly broad utility not imagined 50 years ago,” Pizziconi said.

Dorson and Larsen’s seminal work coincided with biomedical research by other scientists and practitioners around the country, particularly Robert Bartlett, a physician and medical researcher at the University of Michigan, who is known as the father of ECMO.

Applying engineering principles to meet health care needs

When he reflects on his time at ASU, Larsen, now retired, says he never imagined his early research would be a stepping stone to current ECMO devices.

Larsen recalls long periods of painstaking experimentation, working in the lab from early morning until late at night conducting a lot of trial-and-error testing.

Keith Larsen

Keith Larsen at ASU in 1971. Photo courtesy Keith Larsen

Of particular importance, Larsen studied the characteristics of straight and curved tubing for its use with the ECMO device. Because the device can transfer oxygen and carbon dioxide in the same way it is done by the lungs, Larsen used silicone rubber tubing to oxygenate the removed blood. He discovered that coils reduced the length of tubing needed in the device by more than 50%.

Larsen says he is pleased that his research was a success and proved valuable to subsequent researchers.

“I am thrilled when I hear what it is doing (in treating COVID-19 patients) and that ECMO has other medical uses.”

ECMO is also used in heart and lung transplantation. Beyond respiratory distress and failure, the treatment is sometimes used in cases of cardiac arrest, cardiogenic shock, hypothermia and septic shock.

Research collaborators respond to COVID-19 challenges 

The early collaborations of Dorson, Larsen and others established with St. Joseph’s Hospital and the Barrow Neurological Institute, among other institutions, continue to pay off, Pizziconi says, pointing to ASU’s current clinical partnerships with most of the major medical centers in the Phoenix metro area, including the Barrow-ASU Initiative for Innovation in Neuro-Engineering

In addition to Barrow and Dignity Health, which now operates St. Joseph’s Hospital, ASU has formal alliances with Mayo Clinic, Phoenix Children’s Hospital, Banner Health, Creighton University, the Maricopa Integrated Health Center and others.

Such cooperative efforts provide a platform for addressing pressing clinical needs, such as mobilizing in response to events like the COVID-19 pandemic. ASU, for instance, has created a PPE Response Network to provide personal protective equipment to hospitals and community organizations to help prevent infections.

Pizziconi says there are also discussions underway among some of the university’s biomedical engineering researchers and their collaborators on new or modified designs for ventilators to help care for COVID-19 patients.

William Dorson

The late ASU Professor William Dorson was among the first to do research and develop technology that would lead to extracorporeal membrane oxygenation, or ECMO, treatment that aids patients with severe breathing problems. He is pictured at St. Joseph’s Hospital in Phoenix, applying the first ECMO treatment on infants experiencing respiratory distress. Photo courtesy of Vincent Pizziconi/ASU

Use of ECMO requires combination of resources and expertise

Health care experts caution that the technology is not a viable replacement for ventilators in all COVID-19 cases, nor is it always readily available. There are far fewer ECMO systems than ventilators, and ECMO treatments are also significantly more expensive and require an extensive commitment of health care resources to the care of individual patients.

“While it is too early to predict overall mortality and morbidity rates in those COVID-19 patients initiated on ECMO, anecdotal successes with survival to discharge have been reported in several cities in the United States and countries around the world,” said Dr. Ayan Sen, a consultant and chair of the Department of Critical Care Medicine at Mayo Clinic in Arizona.

“We performed what may have been one of the first interhospital transfer of patients to our hospital after initiating ECMO support,” Sen said.

He adds that ECMO is indeed a “resource-intensive” and complex technology, requiring a team of cardiac surgeons, nurses, intensivists and other medical specialists.

“This may be less doable in health care systems that are stressed and overwhelmed, as is evident during this pandemic,” Sen said.

Top photo: Uses of extracorporeal membrane oxygenation, or ECMO, technology, recently approved by the Food and Drug Administration for treatment of COVID-19 patients, have expanded since its development in the 1960s and '70s. In addition to treating acute respiratory distress, it is used in cases of cardiac arrest, cardiogenic shock, hypothermia and other related conditions. Photo courtesy of Shutterstock

Joe Kullman

Science writer , Ira A. Fulton Schools of Engineering

480-965-8122

 
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Social sciences faculty honored with Outstanding Faculty Mentor Award

May 13, 2020

Every year Arizona State University Faculty Women’s Association recognizes exceptional mentors across the university with the Outstanding Faculty Mentor Award. This year, two social sciences faculty members from The College of Liberal Arts and Sciences were selected for the honor. 

“Mentorship is an important part of the college experience and these two outstanding faculty members have shown the positive, long-lasting impact mentorship can truly have on students,” said Pardis Mahdavi, dean of social sciences. “They are deserving of this honor and I am proud they are a part of our community.”

Meet the award recipients, and learn a little more about what makes them outstanding mentors.

headshot of ASU faculty member Amber Wutich

Amber Wutich joined the School of Human Evolution and Social Change as an assistant professor in 2007 after initially coming to ASU as a postdoctoral student in 2006. Today she serves as the President’s Professor of anthropology, the director of ASU’s Center for Global Health and the associate director of ASU’s Institute for Social Science Research.

Wutich, who has won several awards for being an outstanding educator and mentor, is an anthropologist with two decades of community-based fieldwork that explores how inequitable and unjust resource institutions impact well-being, especially under conditions of poverty. Her focus on cross-cultural trends has led her to direct the Global Ethnohydrology Study, a cross-cultural study of water knowledge and management, as well as co-author the book “Lazy, Crazy, and Disgusting: Stigma and the Undoing of Global Health.”

As a teacher, Wutich offers courses and workshops in content analysis, grounded theory, theme identification, systematic coding and research design. In her courses and in her role as a mentor, Wutich strives to create positive change by inspiring students to realize their full potential.

“As mentors, we impact the world most directly through our students and through their impact on the world. I feel honored that students entrust me with the responsibility to help them navigate all of these paths as they complete their education. I’m delighted to have the chance to take on different roles when students need me to do so. Like a boss, I can teach professional skills and hold students accountable. Like a parent, I can nurture students’ curiosity and help them realize their full potential. Like a friend, I can listen and empathize and cheer students on. My favorite thing about being a mentor is the precious opportunity I have to influence and encourage students to change the world.”    

Wutich was nominated for the award by her students and colleagues. Graduate research associate Anaís Delilah Roque said Wutich’s mentorship greatly helped her on a path to success.

“Dr. Wutich is an outstanding mentor because she prioritizes her mentee's personal and professional development. She does this by keeping in contact with students like myself and adjusting our particular needs to be successful in academia,” said Roque. “As a student of color, where English is not my first language, and a first-generation in graduate studies, this is extremely important to me as her support allows me to thrive in this environment.”

headshot of ASU faculty member Tracy Spinrad

Tracy Spinrad is a professor at the T. Denny Sanford School of Social and Family Dynamics and has been with ASU for 22 years. Her contributions to the field of family and human development focus on understanding the factors that predict children’s socioemotional development — with an emphasis on children’s effortful control and how individual differences in effortful control and emotional reactivity predict children's positive and negative developmental outcomes. In her current research, she focuses on children’s feelings of concern and helpful behaviors toward different recipients. 

Spinrad was previously recognized for her exceptional teaching in 2015 with the Zebulon Pearce Distinguished Teaching Award. Spinrad’s current graduate and postdoctoral students nominated her for the Outstanding Faculty Mentor Award, with the effort being led by Diana Gal-Szabo, a PhD graduate student.

“Tracy is truly an inspirational mentor who invests deeply in her students,” Gal-Szabo said. “She has always been there for me both professionally and personally as I navigated my PhD program. I can honestly say that I am a better researcher and human as a result of Tracy's support and guidance.”

After learning that her students had nominated her for the award, Spinrad said she felt overwhelmed and extremely touched to be nominated.

“These are really difficult times, and to be appreciated and honored in this way made me very emotional. My students deserve the credit. They are amazing, and I respect and appreciate them in return for this honor,” she said. “The relationships that I’ve developed with my students bring meaning to my work. It also brings me a lot of pleasure to see my students succeed in their careers and personal lives.” 

In her human development and research courses, and as a mentor, Spinrad said she strives to expand her students' knowledge on the subjects while allowing them to feel heard, valued and respected. 

“Being a faculty mentor is more about developing a partnership. I often think that my graduate students are more like future colleagues than mentees,” she said. “Sure, I can teach students the ins and outs of research with children, and I will challenge them — but they contribute to the learning process as much as I do. There is not one formula for every student, because everyone brings their own unique style, interests and personality to the table. I have also learned that sometimes, when faced with a question from a student, a simple ‘What do you think?’ goes a long way. It shows them that I value and respect their ideas — and often, their answers are more creative and thoughtful than my own.”

Top photo: Arizona State University's Tempe campus. Photo by Deanna Dent/ASU Now

Emily Balli

Communications Specialist and Lead Writer , The College of Liberal Arts and Sciences