ECMO, a ray of hope for H1N1 patients

System acts as an external heart, lung

ECMO, a ray  of hope for  H1N1 patients

The procedure performed at Narayana Hrudayalaya on Srinivas, who was in ICU for 22 days, stabilised his condition remarkably.

Srinivas was admitted to a private hospital on August 2, where he was put in the general ward for four days. He was shifted to ICU and put under ventilator for eight days as his condition worsened. However, he slipped into coma after three days, said Santhosh, son of Srinivas. He was then shifted to Narayana Hrudayalaya and recovered after ECMO procedure for 14 days.

The procedure

Explaining the procedure, surgeon Dr Binoy C, who is in-charge of ECMO unit, said two tubes were fixed on the lower and upper half of the body and the third was fixed to the heart. The first two tubes took the impure blood to the machine, which purified it, and sent it to the heart. "The doctors need to have lot of expertise along with constant monitoring of the patient," he said. The arrangement acts as artificial heart and lung outside the body.

Several H1N1 patients die due to Acute Respiratory Distress Syndrome. In spite of intensive supervision, the patient could develop complications like heavy  bleeding, infection, damage to liver and brain, etc.

ECMO is not a new technology, as it has been used on patients with failed heart for the last eight years in the hospital. However, studies from US, UK and Australia show that the procedure, when used on patients with failed respiratory system, improved the survival rate to 70 per cent.

"We didn't know that it would work on H1N1 patients till some experts from Australia came down for a conference. They told us that they had seen patients responding positively to the treatment," Dr Binoy said.

Srinivas is the second patient to have undergone this procedure but the first to survive. According to Dr Binoy, the first patient, a 52-year-old man underwent ECMO for 40 days and was later discharged. However, within a week he again developed lung infection and died.

The toll

At least 100 people tested positive for H1N1 from September 14-19, a decline over the previous week’s 140 cases.  Majority of the patients reported on September 16. However, there have been no reported deaths. The total toll has gone up to 110 in the State since January this year. 

Dr Binoy felt that H1N1 influenza was very rampant in India, with the Health Ministry data indicating 128 deaths between August 30 and September 5. He also said that according to WHO, the H1N1 causality has increased from under four per cent to almost eight per cent from April, 2009.  

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