Extracorporeal Life Support Helps Patients With Severe COVID-19 Symptoms In Kolkata

Extracorporeal membrane oxygenation or ECMO is used as a heart and lung machine in ICUs. The machine itself does not treat COVID-19 but the health problems that the virus triggers.

Experts have urged Bengal government hospitals to use Extracorporeal membrane oxygenation or ECMO.

Kolkata:

Doctors at private hospitals in West Bengal's Kolkata are making use of a different technique to help certain patients with severe COVID-19 symptoms like pneumonia when even ventilators fail to help with their recovery.

Extracorporeal membrane oxygenation or ECMO, used traditionally for heart surgeries in children, is now helping hospitals in Kolkata after doctors in Gujarat's Ahmedabad registered some success.

Experts have urged government hospitals in Bengal to adopt the same technique.

Abhimanyu Lal, 54, was infected with coronavirus in May and spent 10 days on the ECMO at Medica Superspeciality Hospital in south Kolkata. His lungs were severely compromised and the ECMO acted as an artificial lung while his own healed. For Mr Lal's family, his recovery was a miracle.

Mr Lal's 28-year-old son Rahul had never heard of the ECMO before. "The machine was next to god. God were the doctors and the whole team that saved my father."

The survivor, who owns a dairy business, said: "This (COVID-19) is a dangerous disease. I only pray no one gets it."

Mr Lal was among the 14 COVID-19 patients who were put on ECMO at Medica hospital -- four of them are still on the machine, two are awaiting discharge and five have recovered. Three of the patients, however, died during treatment.

Around 15 years ago, when swine flu hit UK and Australia, ECMO outperformed ventilators, according to Dr Arpan Chakraborty, the critical care consultant who is one of the key leaders on the ECMO team.

"In 2005-06, a landmark trial came out where ECMO saved 50 per cent more patients than the ventilator," he explained. "Usually the lung is like a balloon. It becomes like a brick because of severe COVID-19 pneumonia. At that time there is no option but to rest the lung by taking its action to the ECMO machine and rest the native lung so that it can recover and take over its own faction function after 14 days," Dr Chakraborty said.

The ECMO requires huge team effort, with at least 20 to 25 people working round the clock including nurses, hospital cleaners, perfusionists and doctors.

The machine drains the blood from the patient's body, draws out the carbon dioxide from the blood, warms it to body temperature and puts it back into circulation. It is used as a heart and lung machine in ICUs. The machine itself does not treat COVID-19 but the health problems that the virus triggers.

A 24-year-old woman with COVID-19 was treated at AMRI Hospital at Dhakuria in Kolkata, using ECMO. She was discharged on June 8 after 300 hours on the machine.

A COVID-19 patient in Delhi and another in Chennai, however, died despite being put on the ECMO.

Delhi has used ECMO for five patients, Maharashtra's Mumbai for nine, Ahmedabad for 11 and Kolkata for 20.

Dr Kunal Sarkar, senior cardiologist and vice-chairman at Medica Superspeciality Hospital, said: "The ECMO is hard work. It's a new, challenging technology. At the moment, it is definitely a bit punishing on the budget but has given us some ray of hope in helping people who otherwise wouldn't even have had a 48-hours life expectancy."

Dr Sarkar said the West Bengal government has three ECMO machines which should be pressed into service at the earliest.

West Bengal coronavirus cases crossed the one-lakh mark on Tuesday while the death count rose to 2,149. The total number of people who recovered from COVID-19 in the state was 73,395 on Tuesday, according to the state health department.