CARE Hospitals, Vizag has achieved another clinical milestone! A young woman affected by swine flu (H1N1), as well as compromised lungs, came to CARE Hospitals, Vizag. The traditional life support system was inadequate for her condition and her life was in danger. Then CARE tried the cutting-edge treatment modality, ECMO (Extracorporeal Membrane Oxygenation). The ECMO, supported by an expert team of clinicians, saved the patient’s life. A press meet was held on May 12 to share the success story and the availability of an advanced treatment facility at CARE Hospitals for the people of Coastal Andhra.
Mrs V Kanka Mahalaxmi, 35, wife of an employee of Visakhapatnam Steel Plant was admitted at CARE Hospitals, Ramnagar, Vizag with complaints of fever, cough, diarrhea and breathlessness, with very low oxygen levels in blood and low BP. She was initially treated with fluid resuscitation, non-invasive ventilation (NIV), antibiotics and other medications. She had bilateral severe pneumonia and swine flu. As NIV did not help, invasive ventilation was given, but still there was no improvement in oxygen levels in the blood and her lung condition continued to deteriorate. The patient’s family was counselled about ECMO (Extracorporeal Membrane Oxygenation) with its benefits, possible complications and cost factors. They consented and ECMO was started on 25th April. Cannulations were done by Cardiothoracic Surgeons Dr Karunakar Padhy and Dr M Kishan. After 5 days of ECMO treatment, the patient’s condition began improving. She was on the ventilator for 4 days after ECMO removal, with other supportive care and physiotherapy.
The most advanced therapy may not give the desired clinical outcome, if it is not supported by an expert team of clinicians. Mrs Mahalaxmi was cared for by the Critical Care team – Dr Mohan Maharaj, Dr Lakshmi Rani, Dr Hariprasad, Dr Surendra, Dr Satya Padmaja and Dr Chanikya. Pulmonologist Dr Prem Kumar, CT Surgeons Dr Karunakar Padhy, Dr Kishan, ECMO Clinical Technologist Mr Eswar and ECMO Technician Mr Krishna. The nursing staff gave her excellent care in the ICU and she did not have any complications during her stay. She was discharged on 12th May.
ECMO is the only option for refractory hypoxia, either for lung problems or heart problems or for a patient awaiting a heart lung transplant. It has the added benefits of oxygenating blood outside the patient’s body, as blood flows through the oxygenating pump by the venous cannula and is circulated back to the patient through the venous or arterial cannula (VV ECMO or VA ECMO). The success rate of ECMO is 30 to 50%, if it is initiated in the early stages of lung damage (P/F ratio <100). But ECMO therapy carries a 50% risk of complications (bleeding and infections). On an average ECMO therapy is given for 5-7 days.
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