Fresh lease of life for swine flu patient after ECMO procedure

A 27-year-old swine flu patient from Ghaziabad, who had developed an acute respiratory syndrome, has received a fresh lease of life after she was put on ECMO, an external life support system.
Yashi, housewife and mother of a two-year-old daughter, and doctors under whose care she was treated at a private hospital, today interacted with reporters and shared the challenges they faced.
"She was diagnosed with swine flu in August and when she was shifted to the Fortis hospital, her condition had rapidly deteriorated and she developed difficulty in breathing. Her condition worsened and she was unable to maintain her saturations. So, she was put on a ventilator support.

"Chest x-ray was suggestive of a condition called ARDS. Every possible manoeuvre in ventilator was being tried, but unfortunately the patient did not show any improvement. So, we decided to put her on ECMO," said Sandeep Dewan, Director of Critical Care at FMRI Gurgaon.
Acute Respiratory Distress Syndrome or ARDS is a condition where lungs are unable to function properly and the patient is unable to maintain normal saturations.
"In ECMO (Extra Corporeal Membrane Oxygenation) technique, as the name suggests, a device is connected to the body from outside.

"The blood supply in the veins is routed to the heart through a pump and another apparatus, which perform the function of a heart and a lung, thus allowing cardiac and respiratory support to the patient," Dewan said.

Yashi was administered ECMO in the second week of August and mobilised on it for few days before being shifted to ward and later discharged.
The senior doctor said, the decision to apply ECMO to a patient must be taken within a window of six days from the time the complications are diagnosed, otherwise it is likely to not prove effective.
"In case of Yashi, she was brought to the Fortis Hospital Shalimar Bagh, where her condition was worsening and the family agreed for the ECMO.
"But, since her condition was not good, we brought the ECMO set up to Shalimar Bagh facility and after putting her on it, she was shifted to FMRI Gurgaon," he said.

Dewan said the ECMO can be mobilised in case of patients who suffer from reversible lung or cardiac failure.
"The procedure takes about two-three hours and at our hospital, the survival rate is about 58 per cent," he said.
Delhi-resident Vidushi, 31, who also had been mobilised on ECMO at the FMRI Hospital after being diagnosed with pulmonary tuberculosis, shared her challenges.
The FMRI claimed that it was the "first hospital in the country to administer ECMO on a tuberculosis patient".
Dewan said, the technique is not very prevalent because, vis-a-vis in the West, say in the US, as it needs a lot of expertise. Also, the initial cost of getting the ECMO administered is huge, he said.

The senior doctor said besides, Fortis, the technique is also available for patients at the AIIMS and the Sir Ganga Ram Hospital.