A 19-year-old boy who had attempted suicide was successfully treated with the help of ECMO therapy at SKH, teaching hospital of BU

A 19-year-old boy who had attempted suicide was successfully treated with the help of ECMO therapy at Shree Krishna Hospital, teaching hospital of Bhaikaka University, Karamsad. The boy was referred from Khambhat Hospital.

 

He had ingested two tablets of celphos (pesticide) about a month ago, after which he lost consciousness. Soon after his hospitalization, he was put on ventilator support and shifted to the ICU.

 

His heart function was hardly around 10%, against the normal heart function of 60%. The hospital critical care team works under the leadership of Dr. Samir Patel. Pulmonologists (Dr. Abhishek Prajapati, Dr. Dhaval Prajapati, and Dr. Abhishek Shah) and Intensivists (Dr. Rachit Patel, Dr. Darshan Shah, Dr. Sunil Chhajwani, Dr. Archana Sinha, Dr. Bharat Prajapati, and Dr. Gunjan Desai) decided to give support through extracorporeal membrane oxygenation (ECMO) to the failed heart till celphos poisoning got cleared from his body, as that was the only option for the survival of such a patient. The doctors quickly counselled the patient’s father and uncle and called for VA-ECMO support from Vadodara.

 

The patient was put on VA-ECMO support, and his vitals (pulse, blood pressure) started to improve gradually. He suffered seizures (convulsions) at midnight and was treated on time. His heart function started to improve slowly, and as a sign of relief, within 15–16 hours of starting ECMO, he started to gain consciousness.

 

The multidisciplinary team of the hospital's nephrologists (Dr. Maulin Shah and Dr. Mitesh Makwana), Vascular Surgeon (Dr. Jayesh Shah), Anesthesiologist (Dr. Hemlatta Kamat), Psychiatrist (Dr. Shardul Solanki), Physiotherapist (Dr. Jigar Mehta), Haematologist (Dr. Suraj Goyenaka), Consultant Blood Bank (Dr. Manthan Patel), Neurologist (Dr. Soham Desai, and Dr. Tejaswini Shanubhogue), Radiologist (Dr. Mital Kucha), and Dietitian (Ms. Jigna Patel and Jayanti Antani) provided treatment and care to the patient.

 

The patient suffered multi-organ dysfunction along with kidney failure, which was managed by the nephrology department. Multiple hemodialysis treatments were given. After 40 hours, the ECMO was removed to avoid any unwanted complications. After the patient was off ECMO and treatment of celphos poisoning was successful, he further underwent hemodialysis for kidney failure and severe infection. The ventilator support was removed after a week. And after 25 days, the patient is now normal and off dialysis. He is back with his family.