- ECPR was successfully used for the first time in India for treating a patient who suffered cardiac arrest outside a hospital.
Kochi: Doctors at Aster Medcity gave a new lease of life to a 33 year-old Chittoor native, Jose Biju, who was admitted into emergency department of the hospital in a critical situation after suffering from cardiac arrest while driving. The patient’s life was saved by performing Extra Corporeal Cardiopulmonary Resuscitation (ECPR), a method of cardiopulmonary resuscitation, by using Extra Corporeal Membrane Oxygenation (ECMO), a machine that acts as a heart-lung bypass. Doctors at Aster Medcity said the procedure is rarely used in the emergency department even in the western countries.
Jose Biju was admitted in a critical condition into the emergency department of Aster Medcity on November 1, 2019. The patient temporarily achieved transient return of spontaneous circulation (ROSC), resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest, by giving cardiac massage. But the patient again developed cardiac arrest. As repeated cardiac arrests were likely to affect the functioning of the patient’s brain, Dr. Johnson K. Varghese, Lead Consultant, Emergency Department, consulted Dr. Suresh G Nair, Senior Consultant, Department of Anaesthesiology, about the feasibility of ECMO. After receiving permission from the family members, a medical team comprising Dr. Suresh G. Nair, Dr. Jobin Abraham and Dr. Joel Devasia performed ECPR using ECMO and resumed spontaneous rhythm within 30 minutes.
The patient was then shifted to the cath lab where a medical team comprising Dr. Raja Sekhar Varma, Senior Consultant, Interventional Cardiologist; Dr. Manoj Nair, Senior Consultant Cardiac Surgeon and Dr. George Kurian, Consultant Cardiologist, reestablished flow through the left anterior descending coronary artery. Though the patient was confused and agitated when he woke up the next day after the procedure, he became normal in the next couple of days. The ECMO was removed on the third day. Jose Biju, who was removed from the ventilator on the fifth day, has fully recovered.
“Although we have been using ECMO as a lifesaving technique in various other areas like post cardiac surgery and in patients with severe respiratory infection, it is the first time the technology is being used to save life for out-of-hospital cardiac arrest,” said Dr. Johnson K. Varghese.
Jose Biju, who works as an online taxi driver, had persistent burning sensation in his chest since in the morning. However, he didn’t take it seriously and continued to work. When the pain became unbearable, he called his wife, who is working as nurse in a private hospital in the city, and told her that his chest pain was getting worse. She advised him to immediately reach the hospital where she works. On his way to the hospital, the pain became excruciating and he collapsed inside the vehicle. The patient does not remember what happened to him thereafter.
Jithu Jose, an ambulance driver at Aster Medcity, noticed the incident and with the help of a Good Samaritan shifted the person to the back seat of the car and gave basic life support (BLS) by massaging on his chest. After explaining cardiac massage to the person, Jithu Jose took the patient in the same car to the emergency department of Aster Medcity. The accompanying person was asked to continue massaging till they reach hospital. The doctors said that timely intervention by ambulance driver Jithu Jose, who is trained in BLS, helped to save the patient’s life.
Commander Jelson Kavalakkat, CEO, Aster Medcity, said that Jose Biju received a new lease of life thanks to the combined efforts of doctors and most-modern treatment facilities available at the hospital. He emphasized on the need to train everyone in BLS so that lives can be saved in same situations. Cdr Jelson Kavalakkat also appreciated the selfless act Jithu Jose that helped to save life of a person.