Agra : In a remarkable clinical success, the team of Doctors at Fortis Escorts, Okhla successfully saved the life of a 42-year-old male suffering from white lung using the advanced Extracorporeal Membrane Oxygenation (ECMO) technique. White Lung, or White Lung Pneumonia, is a severe respiratory condition marked by white patches covering the lungs, indicative of extensive inflammation or infection. The symptoms start from upper respiratory infections and then it moves to lower respiratory tract, leading to symptoms like fever, cough, sore throat, watery eyes, skin rash, or even diarrhea.
The patient was referred from a private hospital in Agra, and arrived in an extremely critical condition, with severe breathing difficulties, fever, and coughing with sputum. Upon his urgent admission at Fortis Escorts Okhla, the patient underwent a series of critical diagnostic procedures. A computed tomography (CT) scan, bronchoscopy, and a comprehensive pneumonia panel were conducted, revealing a positive H1N1 infection coupled with Acute Respiratory Distress Syndrome (ARDS). Confronted with rapidly escalating oxygen requirements, our medical team initially administered a high-flow nasal cannula and a non-rebreathing mask to assist his breathing. However, despite these measures and subsequent ventilator support, the patient's oxygen saturation levels remained dangerously low. In response to this critical situation, our team made the decisive move to implement Veno-venous Extracorporeal Membrane Oxygenation (VV ECMO) – a sophisticated and lifesaving intervention. This advanced technique was used as a rescue measure, essentially acting as an artificial lung to provide oxygen and remove carbon dioxide from the blood. Initially, even with ECMO, the patient required 100% oxygen support, and his condition showed no immediate improvement, leading us to contemplate a lung transplant as a potential necessity.
Remarkably, over the following days, the patient's health began to improve gradually under the vigilant care of our ECMO specialists, enhanced antibiotic treatment, and optimized oxygen therapy. As his condition stabilized, we transitioned him from ECMO to mechanical ventilation. This phase included performing a tracheostomy, a surgical procedure creating an opening in the neck directly into the trachea (windpipe), to facilitate more effective oxygen delivery to his lungs. After an intense and vigilant 35-day stay in our care, the patient was discharged in a stable condition.
The team of doctors led by Dr. Avi Kumar, Senior Consultant, Pulmonology, and Dr. Rajat Agarwal – Director, Critical Care Unit, Fortis Escorts, Okhla treated the patient in critical care unit for 2 weeks using ECMO. A lung transplant was a potential option, but we opted for ECMO treatment instead. Timely intervention was crucial, as without prompt treatment, his life could have been at risk.
Giving details of the case, Dr. Avi Kumar, Senior Consultant, Pulmonology, Fortis Escorts Okhla said, “A patient suffering from white lungs is a rare reported condition. Despite initial efforts, there was no noticeable improvement in the patient’scondition, prompting the decision to transition the patient to a mechanical ventilator for enhanced respiratory support. Subsequently, the medical team, in consultation with the family, opted to transfer the patient to ECMO (Extracorporeal Membrane Oxygenation). The family was even prepared for the possibility of a lung transplant. Following multiple bronchoscopies to assess lung secretions and the administration of multiple packed red blood cells (PRBCs) to address blood thinning while on ECMO, there was a positive turn in the patient's condition after a few days.”
Dr. Rajat Agarwal – Director, Critical Care Unit, Fortis Escorts Okhla said, “The patient already had type 2 diabetes and due to viral infection, it caused ARDS. In severe ARDS cases, mortality rate is usually 50-50. But in this case, the patient’s survival chances were extremely bleak. However, with the help of VV ECMO, the patient got a second lease of life.”
Amid the rising cases of ‘white lung syndrome’ in neighbouring China, several states in India are on alert. States like Haryana, Tamil Nadu, Kerala, Uttarakhand, Rajasthan, and Karnataka have asked hospitals and health care staff to be vigilant in handling any spike in respiratory illnesses.
Bidesh Chandra Paul, Zonal Director, Fortis Escorts, Okhla, New Delhi said, “This case was challenging as the patient had severe ARDS and required ECMO which had to be administered. These cases highlight how all efforts to save a patient failed, barring the use of ECMO. Awareness about ECMO intervention at the right time is extremely important among healthcare professionals and families. It is necessary to have option B ready at all times. Fortis Escorts, Okhla is well equipped to handle such cases with modern techniques, and we endeavour to provide the highest quality of care to patients.”
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