Kathmandu, November 3
The Civil Service Hospital in Minbhawan has started operating extracorporeal membrane oxygenation (ECMO) for the first time.
A 43-year-old male patient suffering from severe acute respiratory distress syndrome (ARDS) caused by the influenza virus has recovered after treatment with ECMO. He is set to be discharged from the hospital on Tuesday evening.
The treatment team included Dr Pradeep Tiwari, head of the hospital’s intensive care services, and intensivists Dr Anand Thakur, Dr Santosh Acharya and Dr Birendra Raut. It also included cardiothoracic and vascular surgeon (CTVS) Dr Sampurna Tuladhar, perfusionist Ishan Joshi, anaesthesiologist Dr Deepak Bhandari, and other doctors and nursing staff.
According to Dr Tiwari, who heads the ICU department, ECMO is an advanced life-saving system. For patients with severe heart and lung problems, it takes over the work of the lungs and, if needed, temporarily the heart.
ECMO draws blood out of the body, adds oxygen, removes carbon dioxide and sends the processed blood back into the body.
“Simply put, the patient had a severe lung infection after a viral infection, and a special ECMO machine was needed to let the lungs rest,” Dr Tiwari said. “He was connected to the ECMO machine, and once connected, the machine began supporting his lungs.”
The patient was treated with ECMO support for 11 days and ventilator support for 14 days. He was discharged from the intensive care unit (ICU) on Ashoj 17, and the hospital plans to send him home on Tuesday.
According to Dr Anand Thakur, an ECMO specialist and critical care physician who was part of the treatment, the ECMO system is used in conditions such as ARDS, pulmonary embolism, severe heart attack and heart-lung transplants.
“Another important aspect linked to this achievement is the ECMO retrieval service,” Dr Thakur said. “In ECMO retrieval, a specialist team goes with the necessary equipment to the hospital where a critically ill patient needing ECMO is being treated, starts treatment in suitable conditions, and, if needed, safely brings the patient to a centre that offers ECMO.”
He said running such a service requires immediate assessment of the patient, planning for the transfer, skilled human resources, specialised equipment and effective coordination at the different stages of treatment.
“Starting such a service in Nepal is an important step towards making the country’s critical care services more capable,” he said. “This is also the first ECMO retrieval case in Nepal.”
