5 days ago
No pulse after cardiac arrest, ECMO-CPR revives 56-yr-old
Mumbai: When 56-year-old businessman Nilesh Bhatt began feeling uneasy while visiting a Charni Road temple, he blamed it on the heat. He drank two bottles of water and headed home, but collapsed just as he reached his building.
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His heart stopped. Bhatt suffered an out-of-hospital cardiac arrest. By the time he arrived at the hospital, there was no pulse, no breathing, and a flat ECG. But, with cardiopulmonary resuscitation and about 15 "shocks", Bhatt returned home after a 20-day hospital stay.
His son, Anik, said, "We rushed him in a cab. It was rush hour, luckily. Otherwise, getting a cab in our area is tough."
Cardiologist Dr Maulik Parekh of H N Reliance Hospital who treated Bhatt, said, "No signs of life would be the correct way to describe it.
We immediately began CPR."
After nearly 10 minutes of chest compressions, his heartbeat returned. An ECG showed a massive heart attack. "His heart kept stopping repeatedly. He received 10 to 15 shocks in the first 20 minutes," Dr Parekh said.
Doctors then initiated extracorporeal membrane oxygenation-CPR (ECMO-CPR)—an advanced technique in which a machine temporarily takes over heart and lung function during cardiac arrest.
It buys doctors some time to find and rectify the cause of the cardiac arrest. "We activated our ECMO team within the first 10 minutes," said Dr Rahul Pandit, head of critical care. "It gave us the time to perform an emergency angioplasty," he added.
Cardiologist Dr Milind Phadke from civic-run Sion Hospital said this is the protocol in the West. "But in India, ECMO isn't widely available, and it can take hours to initiate even at hospitals where it is," he added.
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Dr Jumana Haji, who runs the ECMO programme at Fortis Hospital, added, "It takes a well-oiled, round-the-clock team to move that fast."
Bhatt was discharged last week. Anik said, "He was unconscious for eight days after the angioplasty. It was a long wait till he came back home."
The doctors said not every patient is a candidate for ECMO. "But in this case, the patient was at extreme risk. Every minute without oxygen risks serious brain damage," said Dr Phadke.
