Kochi: VA ECMO, an advanced mechanical circulatory support system (MCS), saved a young, critically-ill covid patient’s life at VPS Lakeshore Hospital in Kochi. K M Manoj (30), a resident of Parappupram, Aluva, was presented at the hospital with a three-day history of high grade fever, sweating, and palpitations. The patient had a history of covid infection for ten days and was under home treatment. The renal parameters of the patient were deranged and counts were high and had features of kidney failure at the time of admission. He also had hypotension and breathlessness.
After initial evaluation, he was treated with fluids and high supports to maintain blood pressure. On an ECHO test, the cardiac function of the patient was found to be less than 20 percent. In view of low cardiac output, echo findings, tachycardia, breathlessness and elevated cardiac enzymes, a diagnosis of post covid viral myocarditis was made.
Because of low cardiac output, increased work of breathing, sepsis, and renal failure it was decided to initiate VA ECMO after a multi disciplinary meeting. VA ECMO or Veno-Arterial Extracorporeal Membrane Oxygenation is a support system which aids both heart and lung functions till the organs regain their capability to work properly. This is one kind of modality for patients with viral myocarditis, stress cardiomyopathy, cardiogenic shock, pulmonary embolism, and acute myocardial infarction with cardiogenic shock.
The patient was initiated on VA EMO within 6 hours of diagnosis. During the course of the treatment, his cardiac function improved gradually. By day four, he was decannulated from ECMO. He was extubated from the ventilator and IABP support after two more days. At the time of discharge, his cardiac function showed significant improvement. After 11 days of hospital stay, the patient was discharged on Monday.
“Sudden cardiac death is seen in post covid patients. If we can identify early and give the right treatment, it’s salvageable”, said Dr. Sujith D S, Cardiac Surgeon, VPS Lakeshore Hospital, Kochi.
Along with Dr. Sujith, Dr. M. S. Nebhu (Cardiac Anesthesiologist), Dr. Anand Kumar (Interventional Cardiologist), Dr. Sandhya, Suresh .G (Chief Perfusionist), Geo (Perfusionist), Biji, (ICU In-Charge ), Saumya (OT In-Charge ) and other supporting staff were involved in the management of the patient.