Post-COVID, doctors in Bengaluru are seeing a spike in the number of children with severe respiratory infections (community-acquired pneumonia) requiring hospitalisation. Since returning to their new normal lives, many children have had to deal with various viruses and bacteria. Increased infection rates and severity necessitating intensive care with ventilator support and highly specialised and advanced lifesaving technologies, like ECMO, have been observed.
ECMO (Extra Corporeal Membrane Oxygenation) has been around in India and abroad for a while now, but is extensively used to treat adults.
Over the last two years, the Paediatric Intensive Care Unit (PICU) at Manipal Hospital (Old Airport Road) has been successful in providing ECMO services to five children with severe pneumonia and severely damaged lungs who were unable to recover despite mechanical ventilator support and other conventional therapies.
Shivakumar Shamarao, Consultant and Head — Paediatric Intensive Care Unit (PICU) at the hospital, said, “All the children showed no improvement in lung function and oxygen levels with ventilator support. So, it did not take us long to realise that ventilator support was not enough to treat their lungs, and that the only way to save their lives was to initiate ECMO at the earliest. We are glad that all five attempts resulted in a 100% success rate because if ECMO had not been administered on time, these children may not have survived.”
In the last four months, the PICU team at the hospital has treated two children with pediatric ECMO, he said.
The most recent was a four-year-old girl who was suffering from severe pneumonia and was referred to the hospital from another unit. Her pneumonia was severe to the extent that even ventilator support with maximal oxygen supply could not increase her oxygen levels and make her lungs function properly. She had to be supported with ECMO upon arrival at the hospital. The ECMO lasted for eight days after which she was transferred to ICU for observation.
Another five-year-old child was brought to the hospital with breathlessness. The PICU team diagnosed his condition to be severe pneumonia. He needed ECMO support for five weeks (35 days), as he was unable to breathe without support.
In both cases, there was a long stay in the ICU and follow-up after ECMO treatment.
Similarly, a 14-year-old child with severe pneumonia due to tuberculosis infection, required seven weeks of ECMO after which the condition of his lungs improved.
