ECMO Treatment : Mediciti Hospital’s Proverbial Lazarus Pit

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The cutting edge treatment is a boon for patients in critical condition and for those suffering from incurable diseases.

On April 25, a Malaysian climber was rescued from Mt Annapurna. The tourist was stranded on the mountain and was exposed to sub-zero temperatures for almost two days. He was rescued from camp IV of Mt Annapurna, and was rushed to Mediciti Hospital in Kathmandu via a chopper. After the body temperature started to get better, Cardio-Pulmonary Resuscitation (CPR) was carried out on the patient. As there was no progress in the patient’s condition, the doctors provided respiratory support to the tourist through Extra Corporeal Membrane Oxygenation (ECMO) – a technology that provides cardiac and respiratory support to patients in critical condition.

Mediciti Hospital is the first private hospital in the country to introduce the technology. After providing respiratory support through EMCO for approximately two days, the health condition of the tourist started to get better. Dr Bijoy G. Rajbanshi, head of the Cardio-Thoracic and Vascular Surgery department, led the treatment. The EMCO procedure saved the
patient’s life.

According to Rajbanshi, EMCO technology provides temporary contingency support for patients with special care and support for the heart and lungs. Exterior pumps and oxygenators remove carbon dioxide from the blood and add oxygen back to the patient’s blood circulation.

The ECMO machine is similar to a heart-lung bypass machine. The machine oxygenates the patient’s blood outside the body; as a result, the heart and lungs of the patient’s body can be in rest. When the patient is connected to EMCO, blood flows to the machine – which adds oxygen and extracts carbon dioxide before resupplying blood into the body. The blood is also warmed to body temperature before being pumped back into the body.

“The technology is beneficial when the patients are in critical condition and need artificial support for respiration and the purification of blood,” Dr Rajbanshi says. Besides, the technology is beneficial for patients with aluminium phosphide (Rat poison) disorder. Dr Rajbanshi shares that the number of patients suffering from aluminium phosphide disorder has increased in recent times, and the hospital has been able to save the life of patients with ECMO.

“The technology has played a vital role in saving the lives of patients with aluminium phosphide disorder. We have already used the technology on three patients. In one case, we were able to save the patient with aluminium phosphide disorder,” Dr Rajbanshi says. According to the hospital, the mortality rate of poisoned patients is as high as 97 percent, but the ECMO procedure can minimise the rate to 36 percent.

The technology can be a blessing to cure otherwise incurable diseases such as complicated pneumonia, bird flu, swine flu, among others. EMCO technology has been used to cure complicated diseases such as the ones mentioned above in foreign countries, but it is in the initial phase in Nepal, Dr Rajbanshi shares.

In addition, during transplanting human organs, EMCO provides temporary support to both the lungs and heart. Dr Rajbanshi further shares that the most common conditions that may require ECMO are congenital diaphragmatic hernia (CDH), congenital disabilities of heart and meconium aspiration syndrome (MAS).

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