New Delhi, Jun 1 (PTI) A 44-year-old patient, who was suffering from acute pancreatitis and had battled for survival even on “maximum ventilator support”, has received a new lease of life after undergoing ECMO (extra corporeal membrane oxygenation) therapy at a leading private facility in Gurgaon, hospital authorities said on Wednesday.
In this therapy, blood is pumped outside the patient body to a heart-lung machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the patient.
In a rare case, doctors at Fortis Memorial Heart Institute, Gurgaon, recently successfully treated a scientist who was suffering from acute pancreatitis with the help of ECMO therapy. The patient was presented with acute abdominal pain and breathlessness, FMRI said in a statement.
As the condition deteriorated, the patient had to be put on ECMO, it said.
Investigations based on blood test, ultrasound and MRI of abdomen revealed that a tiny stone from the gall bladder had slipped into the biliary ductal of the patient, blocked the pancreas and caused acute pancreatitis (severely inflamed pancreas), the mortality of which is high even in developed countries.
The patient was immediately admitted to ICU, where a team of doctors led by Dr Sandeep Dewan, director and head of department, critical care medicine and ECMO at FMRI immediately intervened.
As the disease progressed, the patient’s body went into “multi-organ failure” due to extreme inflammatory response which critically affected the functioning of lungs and kidneys. Gasping for breath, the patient was initially managed on HFNC (high-flow nasal cannula) which is a device that supports 60 litres oxygen flow per minute, the statement said.
However, as his lungs were severely damaged and to maintain continuous oxygenation to the body, putting the patient on ventilator was the only option. Other co-morbidities – kidney failure and low blood pressure worsened the patient’s condition, post which he was started on CRRT (Continuous Renal Replacement Therapy – an artificial kidney in which blood is slowly drained from the body into complex tubes and filters as a proxy for kidney function), it added.
Dewan said this was an “extremely rare case”. According to published medical data, very few cases like this have been reported before.
“The patient, a scientist by profession, was battling for his life, even on maximum ventilator support. His oxygen levels were dropping continuously, and the only option left was to put him on VV ECMO (Venovenous Extracorporeal Membrane Oxygenation), it is the most advanced machine which acts as artificial lungs and artificial heart to support the oxygen requirement of the body.
“Fifteen days on ECMO were crucial for the patient’s recovery and survival. Slowly waiting for the lungs to heal, while on ECMO, CRRT and ventilator support all simultaneously, and battling other multiple infections due to underlying inflammation of pancreas, the patient began showing signs of recovery. Post 15 days on ECMO support, the patient recovered,” he said.
There are “very few reported cases” in the world where patients suffering from acute pancreatitis have been weaned on ECMO, Dewan claimed.