Doctors at Burjeel Hospital saved patient with ECMO at the nick of time
United Arab Emirates, Abu Dhabi –16th August 2017: A 44 year old Lebanese national, SW, first started feeling sick after a car ride with a friend who had flu. His initial condition seemed like typical influenza symptoms – a slight fever, runny nose and a persistent cough. “I was worried about my friend being sick when he was in the car with me. I told him to take some time off so he can feel better.”
Days after this incident, SW, was rushed to the Emergency Department of Burjeel Hospital in Abu Dhabi complaining of shortness of breath, fever and a severe cough. The symptoms worsened over time impairing his lungs with a severe reduction in oxygen.
A father and husband, SW tried to contain the symptoms so he would not infect his family. Thinking it was just a casual flu, he opted to treat the symptoms at home. Days passed, he did not get any better. Instead, his symptoms aggravated and he felt very sick. “I couldn't breathe. I felt extremely nauseous and dizzy. Time seemed to slow down with every breath I took as I struggled to fill my lungs with air. I literally felt like I was drowning. I felt helpless,” said SW. At that instant, it was clear to him that it was no simple flu infection, so his family rushed him to Burjeel. He was admitted into the ICU and received oxygen therapy, then escalated to non-invasive mechanical ventilation followed by invasive mechanical ventilation.
With high hopes, his family remained at his side. “We were restless and enormously concerned,” said SW's wife. “When the doctors told us it was severe pneumonia, I began to really worry. I could not understand how a simple flu had taken us to this point.”
Pneumonia is an infection of the lungs, which causes the air sacs to fill up with fluid making it difficult for a person to breath. In a study published by the US National Library of Medicine – National Institute of Health, pneumonia has a 13% mortality rate and adults are very prone to this respiratory disease in the UAE. If caused by bacteria or fungi, pneumonia can be treated with antibiotics; viral pneumonia cannot be treated with medicines.
“After all the ICU procedures had been taken, we decided to place the patient on the ECMO (extracorporeal membrane oxygenation) machine - an artificial lung machine. SW's case is a critical pulmonary condition and time is of the essence,” said Dr. Nehad Nabil Halawa, Specialist – Anesthesia and Deputy Medical Director at Burjeel Hospital in Abu Dhabi. “Pneumonia is very difficult to diagnose and is often either misdiagnosed or caught too late. When the general procedure at the ICU did not give desired results, it became clear that the patient had pneumonia so we took immediate action to place him on ECMO. We needed to relieve his lung and pump oxygen into his blood.”
The ECMO machine mimics a normal functioning lung allowing for gas exchange by adding oxygen and removing carbon dioxide. “If not managed and handled well, cases like these may put a patient at high risk such as bleeding, pump failure, clotting of blood,” elaborated Dr. Halawa.
In less than a week, SW's chest X-ray showed a remarkable improvement in his lungs and his overall condition. “The color returned to my world when I was able to see my husband live normally again,” said SW's wife, “I am sincerely thankful to Dr. Halawa and Burjeel Hospital for saving the life of my husband. Our family will forever be grateful.”