Hyderabad doctors perform rare procedure to save 18-month-old Chhattisgarh girl

She was initially taken to a local hospital and then transferred to Raipur, before airlifting her to Hyderabad.

BySumit Jha

Published May 27, 2024 | 11:40 AMUpdatedMay 27, 2024 | 11:40 AM

Hyderabad doctors perform rare procedure to save 18-month-old Chhattisgarh girl

An 18-month-old severely ill girl from Bhilai in Chhattisgarh was airlifted to Hyderabad after she ingested a mosquito-repellent liquid.

KIMS Cuddles in Kondapur saved the infant after 18 days of intensive care.

After accidentally ingesting a bottle of insecticide, All Out, the girl struggled to breathe.

The toddler was initially taken to a local hospital and then transferred to a facility in Chhattisgarh’s capital Raipur, where she was placed on ventilator support.

Her condition worsened as her lungs began to fail despite being on full ventilator support.

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Airlifted to Hyderabad

A medical team first put her on ECMO (Extracorporeal Membrane Oxygenation) in Raipur at a referring hospital and then airlifted her via a chartered air ambulance to the Begumpet airport in Hyderabad for further treatment, KIMS Cuddles said in a statement on Saturday.

The girl received one of the rarest and most complex treatments, involving the insertion of a cannula near her neck to bypass her heart and lungs, to save her life.

The baby fully recovered after 18 days of treatment, became active, and was discharged in good health with a normal neurological outcome on 23 May.

Transporting children on VA or VV ECMO from one location to another is extremely rare, especially through neck cannulation, making this case one of the rarest in India, the hospital said.

Over the past year, this is one of the few such cases nationwide, it added.

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VV ECMO stands for Veno-Venous Extracorporeal Membrane Oxygenation. It is a life-support technique used in critical care medicine for patients with severe respiratory failure.

“Veno-venous” indicates that blood is withdrawn from a vein (usually the femoral vein in the leg or jugular vein in the neck), oxygenated outside the body, and then returned to another vein.

Meanwhile, Extracorporeal Membrane Oxygenation (ECMO) is a method of providing both cardiac and respiratory support to patients whose heart and lungs are unable to provide adequate gas exchange to sustain life.

ECMO works by pumping blood externally through a membrane oxygenator, which adds oxygen to the blood and removes carbon dioxide, essentially performing the functions of the lungs.

VV ECMO is primarily used in cases of severe respiratory failure, such as acute respiratory distress syndrome (ARDS), where conventional mechanical ventilation alone is not sufficient to support the patient’s oxygenation needs.

It allows the lungs to rest and heal while providing necessary oxygenation and carbon dioxide removal. It is like a temporary helper until your lungs can work better on their own again.

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Exceptional expertise and precision

For children with heart issues and those undergoing heart surgeries, post-operative ECMO is relatively common.

However, in this baby’s case, the problem was with her lungs and heart, and she was very small. Using ECMO through neck cannulation and transporting her from Raipur to Hyderabad without complications, and then from the airport to the hospital, was highly complex and challenging.

The success showcased the team’s exceptional expertise and precision.

“The treatment provided significant support to her heart and lungs. The advanced facilities at KIMS Cuddles, combined with the expertise of a highly-skilled medical team, made it possible to transport her on ECMO from Raipur and treat her successfully,” Dr Parag Dekate, Clinical Director of Pediatrics & Head of Pediatric Intensive Care Unit at KIMS Cuddles, said.

“Experienced cardiac and vascular surgeons ensured precise blood vessel cannulation,” he added.

To date, six cases have involved VA-ECMO via neck cannulation at KIMS Cuddles. This hospital is also capable of E-CPR, which means putting patients on ECMO while conducting cardiorespiratory massage.

Dr Dekate stated that the hospital has performed 15 ECMO procedures in the past three years, which is one of the largest series of ECMO procedures in India for lung-related conditions.

To improve outcomes, they also restore blood vessels. KIMS Cuddles offers ECMO at very affordable rates, and through its Little One Foundation, it provides financial assistance to underprivileged patients, Dr Dekate added.

(Edited by Majnu Babu).