ECMO treatment for severe lung and heart failure

Doctors at Fortis Memorial Research Institute (FMRI), Gurugram, recently treated a 44-year-old patient of Sikkim whose oxygen level was dangerously low even on maximum ventilatory support due to severe pneumonia and ARDS. The patient, Rajesh Lepcha, was airlifted from Siliguri to FMRI and was put on Veno-Venous Extracorporeal membrane oxygenation (ECMO) to support his lungs. The patient underwent successful ECMO treatment performed by Dr Sandeep Dewan, Director and Head, Critical Care Medicine and ECMO, Fortis Memorial Research Institute, Gurugram and his team.

ECMO is known as a treatment which is given to patients with severe lung failure and heart failure when these patients cannot be managed on conventional treatments like ventilator. ECMO is a machine which acts like an artificial lung and heart when both the organs are so much damaged that they cannot support the human body.

Speaking about the case, Dr Sandeep Dewan, Director and Head, Critical Care Medicine and ECMO, FMRI said, “The patient came to us in a critical state wherein his lung was extremely damaged due to severe viral pneumonia and ARDS. His oxygen levels were dangerously low even on maximum ventilatory support. The case was challenging as it involved airlifting the patient on high levels of life support system by FMRI’s critical care team. On arrival, the patient was placed on Veno-Venous ECMO to support his lungs. He was in a critical condition and was kept in ICU for seven to 10 days.”

“The most common patients which are helped and treated by ECMO are swine flu (H1N1) patients, trauma patients, patients of heart attack or heart ailments and patients with drug overdose. Mobile ECMO is a modality where ECMO is started on a patient which is in a remote area as the patient is too sick to be transported to an ECMO centre without the machine. In mobile ECMO, a five-member team goes from FMRI to the remote ICU and puts the patient on ECMO there. The patient is then transferred by road/air ambulance to ECMO centre. The timing of ECMO is most important, sooner the patient is put on ECMO, as per the requirement, the better is the survival rate.”

Lepcha said, “I have been a chain smoker for over 20-25 years and used to have difficulty in breathing on and off over the years. This problem became severe when I was diagnosed with pneumonia and ARDS. I was admitted at the local hospital in Sikkim for four days. However, I was shifted to Siliguri as my health kept deteriorating. My family was scared as my lungs were severely affected and showed no sign of improvement. They decided to put me on ECMO as the only way for me to get healthy. As ECMO is not available here, I was airlifted to Gurugram. I am glad my family took that decision and I am now healthy. I have resumed my work and am fit like before.”

Dr Ritu Garg, Zonal Director, FMRI, said, “Our endeavour is always to provide best-in-class clinical care and 100 per cent chance of recovery to every single patient. Our clinicians and support staff work diligently to deliver global clinical protocols and leverage cutting-edge technology for best possible results. Raising awareness about early consideration for ECMO therapy is very important, so that timely intervention and proper treatment can be ensured.”