Pediatric ECMO

Pediatric Extracorporeal Membrane Oxygenation (ECMO)

Patient Stories

Selma's Story

 

Colds and sniffles are a normal part of every young child's development. But when Selma Rosenbloom caught her first cold over Thanksgiving 2010, at age five months, it started her and her parents on a harrowing journey they will never forget — one that would forever shape their lives. Within days, her breathing became intensely labored, and her oxygen level plummeted to a point where she required admission to the Pediatric Intensive Care Unit (PICU) at NewYork-Presbyterian Morgan Stanley Children's Hospital. There her parents would soon learn she'd need surgery to repair a severely narrowed trachea — the smallest her doctors had ever seen.  Two surgeries, one life support treatment, and four weeks later, she went home.

Thanks to the attention and skills of her world-class care team, Selma is now an active 12-year-old who is planning her bat mitzvah in April 2023 and giving back to other families on similar journeys.

Baby's First Cold

Selma is Cheryl and Bevan Rosenbloom's first child. When she initially became ill, Cheryl likened her breathing to that of Darth Vader. Suspecting respiratory syncytial virus (RSV) or croup, her pediatrician suggested that Cheryl take her to the Emergency Department at NewYork-Presbyterian/Columbia University Irving Medical Center. During a 48-hour visit there, doctors gave her a nebulizer to ease her breathing, but her inhalation only became more distressed. When admitted to the PICU, her parents met Eli Grunstein, MD, an ENT doctor who is now Chief of Pediatric Otolaryngology. He recommended a bronchoscopy to examine her airways.

Due to a condition called "complete tracheal rings," the passageway through her trachea — the windpipe that connects the larynx (voice box) to the lungs — was too small for air to pass through, and Dr. Grunstein said she needed surgery. Fortunately, pediatric cardiothoracic surgeon Emile Bacha, MD, now Chief of Cardiac, Thoracic, and Vascular Surgery at NewYork-Presbyterian/Columbia, had just joined the team that year and was renowned for his expertise in tracheal surgery. But Selma would need to get over her cold first.

On December 13, Dr. Bacha performed a complex operation called slide tracheoplasty to widen Selma's trachea. During the procedure, doctors also repaired a rare congenital defect called a “pulmonary artery sling.” This is a condition where the pulmonary artery — the vessel that brings blood from the heart to the lungs to be oxygenated — is wrapped around the trachea. After the seven-hour procedure, Selma returned to the cardiac area of the PICU.

All seemed well until an hour later. That's when Cheryl and Bevan were asked to leave the PICU and directed a nearby lounge — as their young daughter fought for her life.

Asking for Divine Intervention

PICU nurse Svetlana Streltsova-Verma, DNP — now Patient Care Director, Infant Cardiac Unit, Pediatric Cardiac ICU — noticed that every time she gently pumped air into Selma's lungs, her oxygen level would rise but then rapidly fall. She knew something was wrong and quickly mobilized a lifesaving team. A surgeon re-opened her chest incision in her recovery room and began pumping her tiny heart in his hand. Over the course of the next hour, specialists assessed her condition to determine the cause of her decline.

Cheryl and Bevan, meanwhile, heard everything from the nearby lounge. "It was like a medical drama, and not the good kind," recalled Bevan, "with people screaming 'stat!' and calling in doctors. Some very friendly and calming residents kept us apprised about what was happening, but I thought to myself, 'This is what it's like when your child is dying.'"

The team identified the source of the problem: a blood clot in the area of Selma's trachea repair. They stabilized her and connected her to an advanced life support system called extracorporeal membrane oxygenation (ECMO), which does the work of the heart and lungs so those organs can heal. The doctors also cooled Selma's body to 70 degrees to reduce her risk of brain damage. She also needed a blood transfusion.

"I was reaching for everything. We needed some divine intervention," added Cheryl. "When they put her on ECMO, I called on our rabbi to change her Hebrew name because there is a Jewish Mystic tradition that if you do that and the angel of death visits, it will pass over her. It was the scariest moment of my life."

In addition to the ECMO, Selma would need a second surgery to treat the blood clot as well as further widen her trachea. Dr. Bacha performed that procedure on December 15. During that operation, her doctors were able to take her off the ECMO, and she continued to improve. "Once she was able to be off the ECMO, we knew things were moving in the right direction," said Bevan.

Selma continued to recover and went home on December 24. Over the following months, she would need to return to the hospital a few times to address tracheal swelling, which was treated with steroids, and to have two additional procedures to slowly expand her healing trachea through an endoscope. Her parents remember simple but important milestones that showed them their daughter was going to be okay: taking a bottle again for the first time, moving her head for the first time, taking her first steps.

"As she recovered and grew, we didn't treat her like a sick kid. She hit her developmental milestones within the normal range," Cheryl explained. She has continued to see Dr. Grunstein periodically as well as pediatric cardiologist Stephanie Levasseur, MD, every one to two years.

The Return to Normal

Today Selma lives on the Upper West Side with her parents and her younger sister, Polly. She has no memory of her ordeal, of course, but a light surgical scar on her chest is a reminder. As she gets older, each time her parents tell the story, she picks up some new nugget of information that she didn't quite grasp when she was younger, realizing just how precarious their situation was in 2010. Cheryl and Bevan do not take a single birthday for granted. "We are filled with gratitude," said Cheryl.

They describe their oldest daughter as incredibly kind, easygoing, motivated, funny, considerate, and fearless. Her passions for soccer and dance have taken her into the orthopedic arena more than once, where she has worked with physical therapists to recover from injuries and sometimes talks about possibly becoming one.

As part of Selma's mitzvah project, she assembled and delivered care packages for families spending time in NewYork-Presbyterian Morgan Stanley Children's Hospital with their children over the holidays, consisting of items such as cozy blankets, notepads and pens, and other gifts to make their stay more pleasant. When she delivered them over Thanksgiving break in 2022, it was the first time she and her family had been back on the PICU floor since Selma's stay there in 2010. "It was a very poignant experience for her to see families with babies in the same room where she stayed," Cheryl noted. And it was also nice for her to see Svetlana and some of the other nurses who cared for her in her dire time of need.

"We're so lucky that the cold she caught alerted us to the care that she needed," Cheryl concluded. "And it's not lost on us how fortunate we were to have ended up at NewYork-Presbyterian. Selma is a miracle."