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The extracorporeal membrane oxygenation method (EKMO) is used annually in 35-40 patients in the clinics of the Vilnius University Hospital (VUL) Santara, 60 percent of the cases are due to cardiac pathology, but during this coronavirus pandemic COVID-19 this method had to rescue 19 new virus infections in the VUL Santara clinics. patients.
As in other parts of the world, in Lithuania this method is applied only to critically ill patients, usually after cardiac surgery or due to a very serious lung injury, for whom the risk of death is very high and otherwise not they would have a chance to recover. Currently, the lives of four critically ill patients still depend on the EKMO system, and four have already recovered.
Inga from Biržai district underwent a major test: a woman contracted a coronavirus infection (COVID-19) while pregnant. Upon arrival at the VUL Santara clinic at 21 weeks of gestation, it was clear that the fetus was already dead, but the woman’s life was in serious danger: the condition was critically serious, and the patient had to be intubated and pulmonary ventilated artificial.
According to the head of the department of anesthesiology-resuscitation of the Center for Anesthesiology, Intensive Care and Treatment of Pain, prof. Robertas Samalavičius, the pulmonary ventilation procedure could not guarantee sufficient blood gas circulation parameters, hypoxia severely damaged the lungs, so the extracorporeal membrane oxygenation (EKMO) system was urgently connected to save the patient’s life .
When a coronavirus infection is complicated and the patient is in critical condition due to a particularly severe lung injury, the oxygen saturation of the blood is disrupted. When the EKMO system is switched on, the patient’s venous blood is saturated with oxygen, carbon dioxide is removed, and the blood is returned to the patient’s bloodstream.
“At that time, the lungs were not working at all, but they were replaced by the EKMO system for six days. When the lung function started to improve, it was already possible to disconnect the patient from our device and, a few days later, from the lung ventilator. The woman has recovered ”, says Prof. R. Samalavičius.
According to the director of the Center for Obstetrics and Gynecology prof. Diana Ramašauskaitė, gave birth to 25 mothers who tested positive for COVID-19 at the VUL Santara Clinics Obstetrics and Gynecology Center in 2020: 17 of them were asymptomatic, 8 were mild and only this woman suffered from a serious illness , that doctors managed to save their lives using modern technologies.
Connecting the EKMO system is the method of last resort for the most complex group of patients: initially, the patient begins to lack oxygen and receives additional oxygen; If this is not enough, high-flow oxygen is administered; If this is not enough, the patient is intubated and given artificial lung ventilation, but if the lung membrane is so damaged that oxygen circulation can no longer take place, the only option remains ECM.
Clínica Santara this method, which was initiated by the head of the Center for Cardiac Surgery prof. Vytautas Sirvydis, began to apply in 1999. Initially, the EKMO system was used to replace cardiac function, and in 2009, during the H1N1 flu pandemic, it was also used to replace lung function and, in the same year, to resuscitate to the patient after cardiac arrest.
Connecting the EKMO system does not cure the patient, it just gives you more time to treat the patient by other means. With this method, about 50 percent. patients recover.
Santara Clinics, a tertiary-level healthcare facility, treats patients in the most difficult conditions during the pandemic, whose lives are being treated with modern treatments and technologies.
