A 20-year-old boy who developed severe breathing difficulties due to pneumonia has been saved through the use of supportive ECMO treatment in Abu Dhabi. Sajjad Alam was hospitalised at the Sheikh Khalifa Medical City (SKMC) after presenting to the hospital with severe respiratory distress. He was struggling to breathe, and his oxygen saturation had dropped to an alarming 78 per cent, the hospital said in a statement.

Although he had previously been healthy, Alam’s body mass index was low at 18, which indicated malnourishment. Doctors at the hospital, which is part of the Abu Dhabi Healthy Services Company (Seha) network and a subsidiary of the PureHealth Group, found that Alam’s lungs had failed due to a severe pneumonia that had spread thrpughout his body. The young man was immediately shifted to the intensive care unit and placed on ventilator support.

When Alam’s condition did not improve, his doctors decided to put him on Extracorporeal Membrane Oxygenation (ECMO) to support his breathing. The treatment uses an artificial heart and lung to support the body when a person’s organs are too sick to do the job, and Alam was found to be ideal for it given his age and chances of recovery. “ECMO gives patients an opportunity to survive until we resolve the heart or lung failure or replace them if needed. ECMO is the maximum level of life support, it is basically your heart and lungs outside your body,” explained Dr Mohammed Abdelrehman Shalaby, consultant critical care and adult ECMO lead.

After detailed discussions and weighing the risks, the doctors planned to put the patient on ECMO after six days of ventilator support. Alam was therefore put on ECMO on his 20th birthday.The ECMO team at SKMC consisted of 24 trained experienced specialists that included intensive care physicians, nurses, respiratory therapists, perfusionists, dietitians and physical therapists, providing a multidisciplinary holistic approach to improve the chances of survival.

“We provide ECMO support to babies, children, and adults across two ICUs throughout the hospital. ECMO is more than just a sophisticated state-of-the-art machine. It requires significant dedicated time at the bedside, multiple equipments, and highly trained personnel. It also involves close monitoring and round-the-clock intervention and care for patients,” said Dr Mohammed Amari, division chief of critical care at SKMC.

After almost 10 days on ECMO, Alam’s lungs slowly started showing signs of improvement, and his infection began to recede. Still, the team at SKMC was unable to start the process of taking him off ECMO due to continuous bleeding in his lungs. Several bronchoscopy procedures had to be performed to remove the clots that had formed in the organs.

Finally, after 27 days, Alam was taken off ECMO support and transferred to the general ward.  “I was literally dying, and if it weren’t for the expertise, technology, and the level of care that I received at SKMC, I wouldn’t be here today. They saved my life,” Alam said. Currently, he is able to drink, eat and walk. Aalm’s organs are functioning well, and he is breathing naturally in room air. He talks to his family back home daily through video calls, and has finally been discharged.

“[Alam] is living proof of the power of ECMO. We didn’t give up on this young man, and though the decision wasn’t at all easy due to his condition, ECMO was our only resort to save his life. It is a miracle that he is among us today, and without ECMO, chances were slim to none. The case has shown us that if we persist with ECMO treatment and work together as a team, even severely damaged lungs can recover completely,” Dr Shalaby said.

Credit: Independent News Pakistan-INP