BENGALURU: In a rare case, a 16-year-old girl was put on ECMO (extracorporeal membrane oxygenation) treatment (a machine that does the work of the heart and lungs) for seven weeks, after contracting Tuberculosis (TB).
She was referred from another hospital after she complained of respiratory problems including fever, cough, and pneumonia. Since her lungs were damaged, neither ventilatory support nor medicines were improving her oxygen level. Her blood pressure dropped and she was on multiple high-dose medications to maintain acceptable blood pressure levels.
As the long-term use of a ventilator and other support systems poses the risk of damaging the organs, doctors, after discussing with the family members, we n t ahead with the ECMO “as an alternate option”.
“Seven weeks is a long time for anyone to be on the ECMO. It is meant to give rest to the heart and lungs until they recover. Putting children on ECMO is not common and even if they are, it is usually for one to two weeks at the most. It is generally done post-heart surgery in children and this situation was unusual as she did not undergo any surgery,” said Dr Shivakumar Shamarao, consultant - Paediatric Intensive Care Unit (PICU), Manipal Hospitals.
According to the doctor, the patient developed infection, kidney failure that required dialysis, and bleeding complications “which is a risk factor for ECMO owing to the high dose of blood thinners and liver dysfunction”. They said that it was taking a “long time” for her lungs to recover, and they even discussed it with international centres offering ECMO but they could give an answer on how long the girl should be put on ECMO. Since they could not rule out chances of recovery and the family was hopeful, they went ahead with it.
“It took five weeks for her to show signs of recovery. Gradually, the ECMO support was brought down and the ventilator support was increased, which was later taken off. She underwent a procedure to help her breathe through the tracheostomy tube. She was finally discharged after nine weeks, on condition of oxygen support at home while continuing to breathe through the tracheostomy tube, as her lungs have not fully recovered. Follow-ups will continue until we deem her lungs are fit,” Dr Shamarao adds.