Now, a dash for ECMO machines as post-Covid complications rise
New Delhi: A sharp rise in post-Covid complications and infections has resulted in a sharp rise in the demand for ECMO (Extracorporeal Membrane Oxygenation) machines and ventilator (life-support) beds, both of which are expensive and not easily available in hospitals across Delhi-NCR.
Dr Piyush Goel, Pulmonologist and Critical Care expert at Columbia Asia Hospital, explained: "Basically, blood goes to our lungs from one side of the heart, where it gets oxygenated. From there it again goes into the other side of our heart from where it is supplied to the rest of our body. Now, if the lungs are not working well, we bypass this blood from the heart to a machine, which we call ECMO. In the ECMO machine, there is a coil that gives oxygen to the blood. So, the blood flows through that coil and gets oxygenated and then re-flows to the heart. In this way, we are able to bypass the lungs for some time till they recover."
In the last couple of days, the number of SOS calls by COVID-19 patients and their relatives for ECMO machines and ventilator machines has been intensifying. Civic volunteers, politicians, social activists, healthcare workers, and hospitals have been trying to amplify and fulfill requests for patients who need critical care and all too quickly run out of time.
As of Monday evening, most of the major private hospitals in the city who have these facilities said that they were currently occupied and it might be several days before it becomes available once more to patients on a waitlist running into hundreds.
Out of several hospitals on verified lists being shared on Twitter, this facility is available at very few. Medanta Hospital in Gurgaon and Indraprastha Apollo Hospital in Delhi's Sarita Vihar both said that ECMO machines and ventilator beds, while available, were all occupied. Both hospitals have a waiting list that requires the patient's name, location and contact number.
The hospitals said they get in touch once a machine or bed becomes available. At Sir Ganga Ram Hospital (SRGH) too, all ECMO machines were occupied and were expected to remain so for the next few days.
However, Dr Goel warned that the procedure is complicated and has several associated risks. Dr Goel adds that ECMO can be somewhat successful only if kidneys and heart are functioning well, blood pressure is fine, and condition is not extremely critical and just the lungs are affected.
"You need huge manpower to manage this machine. You have to avoid getting infections from getting into the blood coming out and then re-entering the body," he said.
For critically ill COVID-19 patients this is used as a last resort. "Also, it is a very expensive procedure that requires use of cannulas and central lines, and very few people can afford it.
"In a pandemic situation where staff and resources are already stretched thin, it is very difficult to go for ECMO at this time. Hospitals run ECMO as a separate program for which they have to train doctors specifically and need good critical care nurses and transfusionists. At most hospitals will have 1 or 2 machines and one machine can only service one patient at a time and will be booked upto 15 or 20 days", Dr Goel added.
