A multidisciplinary team of doctors of Apollo Hospitals has demonstrated that Extracorporeal Membrane Oxygenation (ECMO) therapy helped patients who had severe lung injury due to COVID-19 and could not be helped with ventilator therapy to recover.
Since 2010, the hospital has treated 270 ECMO patients. In ECMO, a patient’s blood is purified and oxygenated through large tubes placed inside large veins (close to the heart) and returned back by means of a pump. This was employed in a variety of situations, including poisoning, trauma and infections such as H1N1, pre and post-transplant patients and most recently, COVID-19, a press release said.
“A total of 23 persons infected during the second wave of COVID-19 were placed on ECMO. Of these, 17 are surviving, which is almost 74%. While 10 were discharged from the hospital, two were off ECMO and are recovering in hospital and four are on ECMO. One of them underwent transplantation. We lost six persons,” said K. Madhankumar, senior consultant, Cardiothoracic and Heart and Lung Transplant Surgeon, Apollo Hospitals.
Doctors said they had demonstrated that ECMO was “very effective” in patients who were not treated with conventional ventilator therapy.
“Lungs recover given enough time in a significant majority of patients with COVID-19, the longest showcased today was a case of a patient who was on ECMO for 116 days. Lung transplant may be appropriate in only a tiny minority of patients,” said Paul Ramesh, senior consultant-Cardiothoracic and Heart and Lung Transplant Surgeon, Apollo Hospitals. It was a 28-year-old doctor from Gujarat who was on ECMO for 116 days. This, he said, was the longest bridge to recovery in India.
The average period on ECMO prior to discharge was 60 days. The current survival rate at six months for ECMO patients was 73.9%, which was higher than the global average of 40-50%, he said.
“In fact, awake ECMO with physical and nutritional rehabilitation was associated with excellent survival in our experience,” he added.
Dr. Madhankumar said that in awake ECMO, patients are awake, extubated and not sedated so that they could eat normally and interact with relatives and cooperate with physiotherapists. The results were better in awake ECMO, he said.
The 143-member ECMO team included cardiothoracic surgeons, pulmonologists, perfusionists, nutritionists, technicians and nurses.
Suneeta Reddy, managing director of Apollo Hospitals Group, said the experience and learning of the team would help the hospital across the country.
