HYDERABAD: A 35-year-young pediatrician from Warangal claimed to have become the first Covid-19 patient in South India to defeat the virus and survive after being put on the Extracorporeal membrane oxygenation (ECMO) support for the 12 days. It is not always possible to clinically manage respiratory distress in Covid-19 patients with ventilator support and ECMO is the last option for them.
Dr Dayanad Sagar, a 35-year-old pediatrician from Warangal had contracted Covid-19 and had rapidly worsening oxygen levels.
So he called up his doctor friends at CARE Banjara in Hyderabad and was admitted in the ICU. He was initially managed on high flow nasal cannula device for oxygenation and started on antivirals and medications for Covid-19.
His chest CT scan was concerning with significant severity of Covid-19 pneumonia and he soon worsened to develop ARDS and he knew he was running out of breath and he realized he needed to be put on ventilator.
He discussed with the critical care team treating him and he was placed on the ventilator. He was put on complete sedation on ventilator on prone position for 16hrs every day for the next 1 week and he showed some improvement and was daily monitored closely.
He underwent tracheostomy to connect ventilator through a small tube through his throat. But his oxygenation deteriorated further and he was not responding despite maximum ventilator support. Dr Pavan Kumar Reddy, the Chief Intensivist and his team decided to put Dr Dayanand on ECMO (Extra-corporeal membrane oxygenation), a method in which blood is drawn out of body and oxygen mixed in blood directly using a special by-pass pump-circuit and given back.
With the help of the cardiothoracic surgical team, the ICU room was converted into a mini-operation room and ECMO was instituted. high resistance to heparin, the anticoagulant that is regularly used. They had to use very high doses of heparin with very diligent and careful monitoring as the requirements of heparin continued to escalate, to prevent any clots.
They put him on minimal settings on ventilator and had to do repeated bronchoscopy to clear thick secretions from the lungs. After 12 days of being on ECMO, Dr Dayanand’s lungs started to improve and his oxygen continued to improve and he recovered.