[MUSIC] I'm Yih-Shurng Chen, I'm professor of cardiovascular surgery in National Taiwan University hospital. >> Am Dr. Chih-Hsien Wang, associate professor of cardiovascular surgery in National Taiwan University hospital. Hello, everyone I'm very glad to introduce Professor Yih-Shurng Chen, he's the first surgeon to use the ECMO in cardiovascular surgery. Post cardiotomy shock or cardiogenic shock, we know that the ECMO was introduced to Taiwan in 1990s. So, I'm very glad to bring Professor Yih-Shurng Chen to talk about the history. And the experience of ECMO, the development of ECMO in Taiwan. Hello Professor Yih-Shurng Chen. >> Hello. What is your first image when you saw ECMO in 1990s? >> Actually in Taiwan, we started the ECMO. So so-called Kobori member actually an issue. In Taiwan since 1994, actually the machine came to my hospital. It was wrong. The 1990 I proposed it was important for the leave alternative and patient. But in that time, not so many liver transplant required. To the machine. So, already in my hospital for years, I see the machine at first sight and say, okay, it's quite similar to the machine, we usually use in the operation for cardiac surgery, we call the holla machine, so is a bit militarized of the hollow machine. It has the pump here with the oxygenation, but it do not have the suction. Okay when when the machine was pressed in my hospital people for years and we discussed occasionally to with the talk about the how we are doing and we all were praying to do for the next occasion. But suddenly, a test developed happened in the operational is a urology patient. He received resuscitation in the operation and the patient sees no hope he'll die soon. And the surgeon said okay, we know must go to our ICU when he arrived ICU ecos. So, what can we do for him? Okay, as far as I find that we try this machine in this patient. So this is the old First cases using ECMO 10 years later, we gradually realize the status of the station using ECMO. We call it ECPR. This is the first experience in Taiwan to use The ECMO actually is done a good experience because it prepares you for die immediately, but since then we start to think, okay, it still has some chance to get the opportunity to use this machine for some kind of patient, such as a shock, such as a ideas such as this, so hopeless condition under resuscitation. This is why we develop another program about the ECPR So, I believe in 1994 10 years, over 10 years or 30 years data, we publish our data about the ECPR. Thus, it is changed the whole procedure of the resuscitation guideline, so, we know that in 1980s. When echo was developed by us by Dr. Ballet in Michigan, he used ECMO for neonatal respiratory failure. But in Taiwan, you studied to use the ECMO first In adult, adult patient and cardiogenic shock patients, we know that actually, at that time, it was a contraindication for ECMO to use in cardiogenic shock why you think that It is possible at that time to put on ECMO in the near dying patient. >> Okay because I said before, the machine is similar to the machine we use in the cardiac surgery. So, in the heart machine, the Halliwell, the compressed and the lung will be supported by the nation. So, if we point out the shoulders, I believe, at that time, his work for the shorter support, actually the truth and the fact after years later the puppet but for the longest part, it may be some problems. And in addition, in the time my hospital pediatrician drew for the alts in near April is very few. That's why we thought we support another field for for this ECMO specialist. From the historical view, of course, your success because you publish it the first ECMO ECPR, large scale papers in the Journal of American College of Cardiology The first report of the, largest scale study, of ECPR and in 2008, you also reported more large, and more, solid data. Have a commercial ECPR inland set of course your success. Can you brand more on ECMO CPR the development of ECMO CPR are what is the key point of success. Okay, the point of the success in ECPR. The first is teamwork. You must organize the whole team. Not only yourself unpleasant cannot work anything because the resuscitation procedure is the continuous. Stop the process. Everybody. We are tired during the resuscitation. So, Tim is the most important one. So the second, organize the key, then the work and the desire It means you want to success you want to do your best for the patient. So under corrosion, all the data you have, even that time, we don't have the good solid evidence to prove is the work so you must pay your attention. Pay your patient, more patient to your patient and you are crushing the old data and the army's 30 to publish your data and some follow will follow your Step to achieve this. This this achievement. >> Nowadays ECMO CPR is a scepter for all resuscitation fields worldwide, you'll convince all awards to use it on ECMO in ECPR. In CPR situation, What's the next step opera ECMO CPR, you think you will see the ECMO machine for patient is not unlike or cavius as you see the halloumi the resuscitation on the and ECMO come on what consider the men, the human the whole other the bread, hot lever or individual organ. So is the different viewpoint to the patient. So I believe The ECMO the machine or the device or the design will take the patient as a whole. So that's why you will see the next step for ECMO in may be perfused the individual organ to keep the organ alive. Not only the heart, but also the lever. But more important is bread. I believe now, the brain is a sub problem and men need a body to change the concept of change the status The bread is the less depressed a baseline for the surviving, but can we change it? So, in addition, the echo has a pump, a profusion machine. He also has a temperature control we can use the pebble control to control the body temperature, local temperature and so on and we also have the possibility to individual perfusion, the individual organ if there are some additional preservation solution for the individual good I can see in the future they will may have some great idea of crazy idea crazy development or comes out. >> Is that a dream or is an ongoing project I think is the train as well as their ongoing project. Everybody we're thing more such as the day I believe a lot of the drug or medication and the vacation to prove or improve the organ visit preservation to improve the is key may refer you injury even In the present, this medication cannot be applied in the human. But for 10 years or 20 years later, I think you will change the whole situation we have now. >> So Professor Chen always on the sunshine side. Of course, he makes many, many efforts to improve survival chance of cardiogenic shock patient. So thank you very much. Professor Chen. >> Thank you.