Extracorporeal Membrane Oxygenation: How A Life-Saving Technique Helped 51-Yr-Old With Viral Pneumonia

A doctor said that considering the 'severity' of illness and 'rapidly-worsening' oxygen and blood pressure, an advanced life support system called extracorporeal membrane oxygenation (ECMO) was given to the patient.

A 51-year-old patient recently underwent a life-saving technique, prior to which she was admitted to a hospital near Hyderabad for the treatment of severe viral pneumonia. The woman's condition deteriorated rapidly. While she was initially placed on non-invasive ventilation, when her condition did not improve, invasive mechanical ventilation was initiated with very high oxygen support. Severe viral pneumonia happens when there is an infection of the lungs caused by a virus. While the most common cause is the flu, one may also get viral pneumonia from common cold and other viruses. Germs usually stick to the upper part of the respiratory system; when they slip into the lungs, the condition deteriorates. The air sacs in the lungs can get infected and inflamed, and they may fill up with fluid. Read on to find out what happened.

An Extremely Serious Case

In this patient's case, her condition worsened and medications for maintaining blood pressure were administered. Since her chances of survival were 'very low', she was shifted to Yashoda Hospitals. Dr Visweswaran Balasubramanian, consultant interventional pulmonology and sleep medicine at Yashoda Hospitals Hyderabad and team in the ICU handled her case.

The doctor said that considering the 'severity' of illness and 'rapidly-worsening' oxygen and blood pressure, an advanced life support system called extracorporeal membrane oxygenation (ECMO) was given. After almost seven days, the patient was 'gradually removed' from ECMO and kept on invasive mechanical ventilation. "In the due course, the patient started gradually showing signs of improvement and was shifted to oxygen as her lung condition improved. Currently, the patient has recovered completely and is able to perform her normal day-to-day activities without any respiratory complaints or oxygen support," the doctor said.

What Is Extracorporeal Membrane Oxygenation?

Extracorporeal membrane oxygenation, said the doctor, is a life-saving technique used in critically-ill patients to support them. "This patient is an example of many who can benefit from ECMO, if it is initiated at the right time. It is [given to] patients with advanced respiratory and cardiac failure. The indications for ECMO vary depending on the underlying condition, and can be broadly categorised into respiratory and cardiac indications."

Why Is It Important?

According to the doctor, for respiratory failure, ECMO is often considered when conventional mechanical ventilation fails to provide adequate oxygenation and ventilation. Common respiratory indications include acute respiratory distress syndrome (ARDS), pneumonia, severe asthma, and pulmonary embolism. "In these cases, ECMO can provide temporary support to allow the lungs to rest and heal while maintaining oxygenation and carbon dioxide removal."

In cardiac failure, ECMO is 'utilised to support patients with severe myocardial dysfunction, or as a bridge to definitive therapy such as heart transplantation or implantation of a ventricular assist device'. Cardiac indications for ECMO include cardiogenic shock, myocarditis, acute myocardial infarction, and postcardiotomy syndrome. "By bypassing the heart and lungs, ECMO can provide circulatory support and improve tissue perfusion, while allowing the heart to recover or facilitating transfer to advanced cardiac interventions," Dr Visweswaran explained.

Outcomes Of ECMO

Its outcomes vary depending on several factors, including the underlying condition, patient's overall health, duration of ECMO support, and complications associated with the procedure. ECMO can significantly improve survival and long-term outcomes in carefully-selected patients. "For respiratory failure, studies have shown ECMO can improve oxygenation and reduce mortality in patients with severe ARDS, who fail conventional therapy," said the doctor.

Are There Any Risks?

ECMO risks include bleeding, infection, thrombosis, and complications related to prolonged immobility. Patient selection and timing of ECMO initiation are crucial determinants of outcomes in respiratory failure, the doctor noted.

He concluded by saying that in clinical practice, ECMO remains a 'valuable tool' in the management of acute cardiac failure. "In addition, with upcoming lung transplantation, initiation of ECMO in select patients can offer a new lease of life till they await transplantation."