Narayana Hrudayalaya has installed an artificial heart & lung system known as the Extra Corporeal Membrane Oxygenator (ECMO). The hospital can now offer complex treatment for patients with H1N1 flu suffering respiratory failure. Using the machine, the hospital which is the only facility in the country to have an organized programme for ECMO support has been successful in saving a patient with H1N1 respiratory failure.

Almost all the H1N1 deaths are due to acute lung failure, Acute Respiratory Distress Syndrome(ARDS). Many cases cannot be managed even with ventilatory support. This is the first instance of using ECMO for this condition in the country, stated the hospital authorities.

ECMO is a complex system which serves as a heart & lung outside the body. The impure blood is taken out of the body and goes through the machine which purifies it and then oxygenated blood is returned to the body through a complex system of channels. Connecting a patient in ARDS to the ECMO provides the diseased lung with the rest required to clear the infection and regain its function. Managing a patient on ECMO requires a well organized effort of a team of experts including a cardiac surgeon, pulmonologist, anaesthetist, critical care specialist, perfusion scientist, physiotherapist and nursing staff.

Since this is a complex system which requires considerable expertise, few centres globally are equipped to provide the service. USA and Australia have reported good survival rates in these patients who were otherwise doomed to succumb to H1N1.

At Narayana Hrudayalaya a 57 year old man was referred for admission with H1N1 influenza. He was on ventilator for a week before his condition worsened. The hospital team headed by Dr Binoy, a consultant cardiac surgeon connected the ECMO. The patient was maintained on ECMO support for 15 days and his condition gradually improved. Now the patient has recovered well enough to be discharged.

According to the World Health Organisation, worldwide so far H1N1 has claimed 25,174 lives of the total 14,835,20 diagnosed cases. In India the death toll is 2,241 so far. The cause of death most often is acute respiratory failure because of ARDS. In addition to the antiviral antibiotic oseltamivir (Tamiflu) the respiratory failure requires ventilator support. Many a time this also fails to save the patient and the only hope at this stage is connecting the patient to an artificial heart & lung system called ECMO, stated the hospital.