Primary Hybrid ECMO at Apollo Kolkata

It was a nightmare in Pulmonary Critical Care when a 57-year-old gentleman was admitted with breathlessness and fever with progressive drowsiness. After intubation, it was impossible to ventilate such tight rigid lungs even with a peak pressure of 100, bronchoscopy revealed grossly inflamed mucosa with a purulent discharge without any obvious collapse.
Meanwhile, his Pco2 mounted up to 200 with a pH of 6.85 and unstable hemodynamics set in. Echo revealed EF of 22% with gross biventricular dysfunction.

He was rescued on primary hybrid ECMO ( V-AV) through the percutaneous Femoro-femoral route and both heart and lungs rested for the next 72 hours. Upon improvement of pulsatility and LV function, the arterial support is taken off and continued respiratory support on VV ECMO.
2-days after, a successful trial-off resulted in the decannulation of VV ECMO and he was weaned off the ventilator.

A primary hybrid ECMO can result in remarkable recovery in cases of septic myocarditis with respiratory failure when conventional therapy fails. The family remained grateful to such fantastic technology for his ultimate recovery.

Apollo Kolkata ECMO Team
#ECMO@apollokolkata