Chennai, September 17th, 2020: Gleneagles Global Health City, Chennai, the largest facility of Gleneagles Global Hospitals Group, has successfully treated a 58 years old patient from Chennai who was detected with post-COVID Respiratory failure. This is the first successful post-COVID respiratory failure treatment through ECMO (Extracorporeal Membrane Oxygenation) in Tamil Nadu. The team of medical experts spearheaded by Dr Govini Balasubramanian, Dr Subramanian Swaminathan, Dr Rajavel, Dr Sivasailam & Dr Suresh aided in the incredible recovery of this patient to a stable condition.
The patient was healthy and without any co-morbidities till July 2020. The patient developed fever and breathing difficulty in the month of July’20 and underwent treatment for severe COVID in a neighbourhood hospital for 14 days. He was subsequently discharged with RTPCR negative. After a couple of weeks of COVID treatment, his blood oxygen levels continued to drop below a critical level and he was referred to Gleneagles Global Health City for progressive respiratory failure and severe lung injury.
Patient’s oxygen level during admission at our hospital was critically low and the CO2 level in the blood was 4 times higher than the normal level due to severe infection in the lungs, said Dr Govini Balasubramani, Senior Consultant – Cardiothoracic Surgery, Heart & Lung Transplantation, Gleneagles Global Health City. Despite the conventional measures like ventilator & prone ventilation support his oxygen levels did not improve and PH level in the blood dropped to 6.688 (normal PH level should be from 7.35 to 7.45). Normally such low PH would cause severe multiple organ damage mentioned Dr Govini.
Due to persistent low oxygen levels despite conventional methods, the Clinical team took a cautious decision to put the patient on ECMO support as it was the last option for his survival. The patient was with ECMO support for 16 days and showed gradual improvement in his oxygen levels. On the 18th day of ECMO, the patient was weaned from ECMO after his lungs started showing good improvement. On the 20th day since admission, the patient became stable and was weaned off from ventilator support as well. The patient currently has recovered completely and is on minimal oxygen support.
“ECMO should be reserved for those patients who are critically ill. In the current times with the COVID situation, we are seeing more and more critically ill patients. The ECMO is resource-intensive and requires clinical abilities, understanding and experience to obtain the best results. This is the first successful post-COVID respiratory failure treatment through ECMO in Tamil Nadu” said Dr Govini Balasubramani, Senior Consultant – Cardiothoracic Surgery, Heart & Lung Transplantation, Gleneagles Global Health City.
“COVID is preventable with basic measures like mask, distancing and hand hygiene. Those who contract COVID can be treated if they reach medical center early. Our patient has already been treated for COVID in another hospital and presented to us more than 2 weeks later with severe lung injury. Treatment provided to him was a combination of ventilation, ECMO and medical management. The patient had a massive clinical improvement and now needs very little oxygen.
Some patients who present late can develop severe complications like lung injury (ARDS). Options like ECMO could be lifesaving in some patients and prevent the need for lung transplantation by allowing the patient’s own lung to heal. This is a complicated multi-disciplinary effort and has best outcomes in centers that have experience in this modality. ECMO is a risky intervention which carries the dangers of infection and bleeding. Hospitals which have good infection control practices usually have better medical outcomes. Gleneagles Global Health City, as India’s largest lung transplant center has significant experience in ECMO utilization” mentioned Dr Subramanian Swaminathan, Director – Department of Infectious Disease & Infection Control.
“To sustain life in critically ill COVID patients, there is a need for a multi-disciplinary approach in treatment. This is a classic example where the entire team of various specialists along with paramedics and allied health professionals worked synchronously round the clock to ensure the best possible care and quick recovery of the patient. ECMO involves a lot of complications that could go wrong if appropriate monitoring and interventions are not administered. The patient faced multiple challenges during ECMO including bleeding, infections, psychological stress, etc. which was handled ably by a team of vigilant intensivists who were instrumental in the recovery of the patient” – added Dr Rajavel & Dr Sivasailam, Consultants – Department of Critical Care at Gleneagles Global Health City.
“ECMO should never be considered primary therapy for any form of acute lung injury. It should be considered as a rescue therapy. If ECMO is considered as the option for COVID treatment, we should timely refer to a tertiary care center with established expertise and standardized ECMO protocols” quoted – Dr Suresh Sagadevan, Consultant- Interventional Pulmonologist, Institute of Pulmonary Critical Care Medicine & Lung Transplantation.
“GGHC, Chennai has been at the forefront of providing world class cutting edge medical care from routine OPD care to Multi-Organ Transplants. Since we started treating Covid 19 patients in 2020, the GGHC team has developed and implemented the best possible treatment protocols for mild Covid cases starting from Home based Covid care to severe cases requiring NIV and even ECMO. I congratulate the Doctors, Nurses & All support staff of GGHC for this outstanding achievement” – Dr Alok Khullar, Chief Executive Officer, Gleneagles Global Health City, Chennai