The story of the survival of a newborn with severe Meconium Aspiration Syndrome and cardiorespiratory arrest by using ECMO

Abstract

Extra Corporeal Membrane Oxygenation (ECMO) is used as a rescue therapy in cardiac and respiratory failure until the reversible condition settles. It provides extracorporeal circulation for gas and heat exchange before entering the patient. While the use of ECMO has been advancing as a promising life-saving modality since 1953, our country still lags behind, having only one ECMO centre for the whole country. The need to improve ECMO is emphasized by the fact that candidates who had grim prognosis being survived by using ECMO. This is the story of a term baby weighing 3770 g who had severe meconium aspiration at birth, requiring intubation within first hour for severe respiratory distress. Irrespective of High Frequency Oscillatory Ventilation and four inotropes baby had refractory desaturation, hypotension and rising oxygen index with a cardiac arrest needing both cardiac and respiratory support for survival. Baby was commenced on Veno-Arterial ECMO monitoring vitals, cardiac status respiration, coagulation, cerebral status for haemorrhage, electrolytes, renal and liver status while treating for sepsis. Our baby fully recovered without complications, while precious smile on the face of the baby highlights an important point, Hi-Tech measures in proper manner do account for their survival and normal development. Progress beyond 'Ambulatory-ECMO' shows how advanced technology can be well utilized for patients' benefits. It is important to expand and improve ECMO facilities in Sri Lanka aiming at a better survival of our patients.