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A machine developed in the early 70’s has turned out to be a miracle for patients in the UAE who were adversely affected by Covid-19.
When the pandemic struck, the world went into a panic state, but quick understanding and awareness from the doctors at the Dubai Hospital have saved many lives with the help of ECMO- Extra corporeal membrane oxygenation.
Dr Obaid Aljassim, consultant cardiac surgeon and head of cardiac surgery and his team successfully treated many patients diagnosed with lungs failure and had no hope of survival.
The technology was brought to the Dubai Hospital in 2013 and was primarily used to treat heart and lung, failure patients.
The ECMO machine is showcased at the Dubai Health Authority Pavilion in Arab Health and Medlab Middle East Exhibition and Congress 2022. To understand how ECMO machine functions, Khaleej Times caught up with Dr Fayaz Khazi, consultant cardiothoracic anaesthetist at the Dubai Hospital.
“We had knowledge of the wonders that the machine can do and understand the adverse symptoms of Covid-19 which is a respiratory failure, the machine was capable of treating the patients that condition.”
The first ECMO treatment for a Covid-19 patient in Dubai was given to a Filipino national in February 2020 who had almost no chance of survival, said Dr Khazi. Since then, the ECMO machine has grown in numbers for patients diagnosed with respiratory problems due to Covid-19 in the UAE. “The patient was at a private hospital in Dubai, and our team had to visit the hospital as we were not aware of the infection control policy because the disease was relatively new to all of us,” highlighted Dr Khazi.
Before subjecting the patient to ECMO, he was put on a ventilator, and maximum oxygen was given out but was unable to oxygenate him at the private hospital and showed no signs of recovery.
“We did not shift the patient to our facility as we did not want others to get infected,” said Dr Khazi. The patient was brought to the Dubai hospital post establishing infection control.
“He walked out of the hospital after 40 days of treatment subjecting to ECMO,” Dr Khazi added.
Dr Khazi also pointed out that many patients affected by covid-19, even close to lung failure, were treated with the machine.
“So many patients have been treated from Covid-19 after subjecting to ECMO. Covid-19 has made the Doctors in Dubai expert in ECMO treatment of heart and lungs.”
This machine now can be seen in many Dubai hospitals due to its role in treating adversely affected patients.
ECMO is an advanced therapy for the treatment of heart and lung or combined, when not treated by a ventilator, oxygen therapy or cardiac surgery.
A pipe is inserted from the groin area in the body, connected to the machine that drains out the blood. The blood then enters the machine equipped with an oxygenator that oxygenates the blood and enters the body by a pipe that is inserted into a vein from the cervical spine.
“As this process continuous, the organ which is being treated either lungs, heart or both is subjected to rest to recover on its own,” said Dr Khazi.
For treatment in heart failure, Dr Khazi said that the oxygenated blood is directed into a major artery near or of the heart.
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“It is not a simple task,” said Dr Suresh Babu Robert, a senior clinical perfusionist at Dubai Hospital, considering the clotting of blood once it’s out of the body. “We give anticoagulant or anti-clotting drug to avoid clotting,”
The machine is equipped with a monitor that reads the contents, pressure, oxygen level etc., of the blood. “We have to keep the patient under observation and titrate the pressure and the volume of the blood going back to the patient’s body,”
Dr Babu stressed the successful treatment of patients in the UAE by ECMO, matching international standards. “The international survival rate of a patient subjected to ECMO for lung treatment is 5 out of 10, and heart treatment is 4 out of 10, and these numbers are same in the UAE.”
Robert Bartlett developed the machine in the early 1970’s. He is an American Physician and Medical Researcher who pioneered ECMO. In the beginning, newly born with breathing problems were subjected to ECMO. “It has great results. But the results were not satisfactory with the adults in the beginning,” said Dr Khazi.
“But during H1N1 influenza in the 90’s, the adult patients with respiratory cases have excellent outcome post ECMO treatment. Since then, the machine is used for the adults,” Dr Khazi concluded.
ayaz@khaleejtimes.com
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