New Delhi: A team of doctors, led by Dr Vivek Nangia, head and director – pulmonology, at Fortis Flt Lt Rajan Dhall Hospital here, have treated a critically ill patient suffering from interstitial pulmonary fibrosis (IPF) and chest infection resulting in ARDS (acute respiratory distress syndrome) using extra-corporeal membrane oxygenator (ECMO). This makes her the first and the only IPF patient in India to survive after being mechanically ventilated and weaned off using ECMO, according to the doctors.
Patient of ECMO: The fifty-five year old woman had been suffering from IPF, a chronic lung disease which results in worsening breathlessness due to progressive shrinkage of the lungs. She was on regular oxygen and BPAP (bilevel positive airway pressure) at home for more than two years. She arrived at Fortis, Vasant Kunj with severe chest infection resulting in a total white-out of both lungs. She also suffers from other illnesses like diabetes, hypertension, hypothyroidism and coronary heart disease. Despite extensive medication, her condition continued to deteriorate and she had to be put on invasive mechanical ventilator, according to a statement by Fortis Hospital.
"There is no definite treatment for this disease and such patients usually survive for only 2-3 years. Death usually occurs due to respiratory failure and it has always been a great ethical
dilemma whether to put such patients on mechanical ventilator or not, as the chance of being liberated from the ventilator is hardly any," said Dr Nangia.
This is when the team decided to use ECMO, a modality that has never been used in India in such a patient before. ECMO is a system which provides heart-lung bypass support outside of the patient's body. It is a technique which uses a pump to circulate blood through an artificial lung and then back into the bloodstream after correcting the blood gas balance, the statement said.
“Within 3-4 days of initiating the treatment, the patient started showing dramatic improvement and could be taken off the ventilator. On the seventh day, she was weaned off the ECMO and discharged on the sixteenth day,” according to the statement.
ECMO not only protects the patient from complications associated with the ventilator but also provides the patient the freedom to speak, eat and perform all routine activities. From mechanical ventilation and a grim prognosis, the patient was able to walk out of the hospital with her family on the day of discharge, the statement said.
"We were prepared for the worst as her surviving the ventilator seemed almost unlikely. However, this treatment saved her life and my wife was back on her feet on the day of her discharge," said the husband of the patient.