#02Sending "Hope" with Collaboration Across Borders
Swiftly Delivering ECMO to Patients in China

Extracorporeal Membrane Oxygenation (ECMO) is used to provide cardiopulmonary support for critically ill patients with severe respiratory or cardiac failure. This system is now also being used for critically ill COVID-19 patients. Terumo’s ECMO was delivered as medical aid to some hospitals in Wuhan in China’s Hubei province on March 6, 2020 just when the COVID-19 pandemic began spreading around the world.

  • Sales associate at Terumo’s Wuhan Office delivering the product to the hospital

Only a month before that, in early February when COVID-19 cases were rapidly increasing in China, the use of ECMO was advised as a life-saving treatment for critically ill patients in guidelines issued by the Chinese government. However, all the ECMO systems in China were dependent on foreign imports rather than being domestically produced. As the number of critically ill patients increased along with the spread of the virus in Hubei province, China issued the order to procure ECMO systems from locations all over the globe and use them to keep mortality rates from rising.

To accommodate this, Terumo decided to donate an ECMO system immediately to a medical institution in Wuhan. Associates at Terumo Medical (Shanghai) Co., Ltd. confirmed the required procedure to the relevant government agencies in China and communicated these to East Asia headquarters office in Japan. They enlisted cooperation from three production plants in Japan and set the wheels in motion to be able to procure the disposable kits including oxygenators and the tubing sets to connect patients’ blood vessels with hardware that controls extracorporeal blood circulation.

However, Terumo’s ECMO was still not approved for clinical use in China. As a result, various forms requested by the Chinese authorities had to be submitted along with the donations. Working closely with departments related to regulatory affairs and quality assurance, just within a week, they were able to finish gathering and producing all the required documents and made it possible to bring the emergency import to China.

Although, some adjustments to conform with China were also necessary in the transport process, thanks to speedy arrangements by departments responsible for the supply chain, the system was smoothly loaded onto a boat bound for China.

The full shipment of medical aid thus departed from Tokyo on February 27, arriving in Shanghai on March 2. Careful advance preparations by Terumo Shanghai reduced the time taken for customs procedures from the usual ten days to only three, and the shipment reached the warehouse on March 5. Terumo’s ECMO was then delivered to the recipient hospital the very next day. As a result of collaboration from many different parties involved, the ECMO system delivered to the hospitals in Wuhan within the shortest possible time is now serving critically ill patients in the medical setting.

  • The complete set of Terumo’s medical aid ECMO systems

The Chinese words meaning “Friendship keeps us close, even when thousands of miles away” were printed on the medical aid boxes shipped to China. These words come from a poem written by Zhang Jiuling, a poet from China’s Tang Dynasty. Underlying this cooperative aid effort between associates in Japan and China against COVID-19 is the shared ideal of the Terumo Group’s corporate mission “Contributing to Society through Healthcare.”

A Sales Associate at Wuhan Office Commented,

In January 2020 traffic was shut down due to the COVID-19 outbreak, and our bustling city was ground to a halt. It was a Lunar New Year that I will never forget. However, many friends not only in China but also other countries including Japan reached out to help us in Wuhan to overcome our difficulties. Thanks to their bonds of goodwill, I strongly felt that even if our city and streets are closed off to the world, love will still shine through.

The way we do our work since the COVID-19 outbreak has greatly changed compared to before. However, we still strive to consistently provide the same timely, high-quality services for our customers with the same passion as always. Utilizing the knowledge and skills we have gained at Terumo we will all work hard together to live up to the confidence placed in us and make our city even more lively and prosperous than ever.

What is ECMO?

ECMO is short for extracorporeal membrane oxygenation. When used for cardiac support it is referred to in Asian countries such as Japan and South Korea as the PCPS (Percutaneous cardiopulmonary support) system.

A venous catheter is placed in the femoral vein for blood extraction and the tip of the venous catheter should be maintained near the junction of the inferior vena cave and right atrium. Blood drained by a centrifugal pump is oxygenated through a membrane oxygenator outside of the body and then the blood is returned to the body of the patient. Thus, it replaces some the function of the patient’s heart and lung.

There are two types of ECMO; veno-arterial (VA) ECMO and veno-venous (VV) ECMO, in both types, blood is drained from the venous system. The blood is returned to the arterial system in VA ECMO such as cardiac support for patients in cardiac arrest. On the other hand, the blood is returned to the venous system in VV ECMO such as respiratory support for patients with acute viral pneumonia associated with COVID-19.

Linguistically, ECMO is often confused with heart-lung machines and ventilators. Generally, heart-lung machines are large instruments used to replace the functions of the heart and lungs when performing heart surgeries during which the heart is stopped. Ventilators are instruments that carry oxygen and air to the lungs through oxygen masks and tracheal tubes.

  • This schematic shows how the cycle works when used in emergency medical procedures

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