Believe It Or Not – It Is Resurrection Of A Young Life
27 years young man gets a “rebirth” or “resurrection” to life at Kauvery Hospital, Chennai.
The team successfully resuscitated the patient with nil neurological defects.
“With a downtime of 20 minutes to reach hospital, he survived massive cardiac arrest with zero brain damage” A sudden cardiac arrest can be fatal if not treated within 8 minutes and it will lead to deprivation of oxygen to brain, thus leading to brain damage.
27 years Mr. MS was brought to Kauvery Hospital Emergency Room in the late evening hours with no signs of life; he had suffered a sudden cardiac arrest at home preceded by intense chest pain. His downtime to reach the hospital was just around 20mins. The team immediately started appropriate and advanced cardiac life support resuscitative measures; he received many a shock with vain; his chances of survival was remote with high likelihood of brain damage leaving him in a vegetative state going by all the past experiences globally. Against all odds, the efforts to revive this young gentleman was going in full swing for over 30mins; briefly he got back the heart beat only to slip back soon into cardiac arrest. Hopes became grim as he started sinking again. His young wife was informed of the bleak survival chances.
This being the scenario,
Kauvery Hospital one of the leading healthcare chains in Tamil Nadu, successfully revived this young victim of ‘out of hospital’ cardiac arrest. Having already surpassed the window period of any likely revival back to life and being pulseless and no oxygen level or BP recordable, active cardiac resuscitations were continued.
Cardiologist immediately transferred the patient to the
Hybrid Cath Lab and an emergency V-A ECMO support (Extra Corporeal Membrane Oxygenator) was initiated in no time. The
ECMO instantly started supporting the functions of lung and heart with its pump outside human body, while also maintaining oxygen supply and the blood flow to the vital organs – the brain, the kidney and the liver etc in the absence of heart beat and cardiac standstill” says Dr Manoj Sivaramakrishnan, the Senior Interventional Cardiologist at Kauvery Hospital Chennai.
He further adds, “While the patient remained in cardiac arrest, ECMO assisted in successful high risk angioplasty with bioresorbable coronary scaffold (dissolving stent - another novel treatment in heart disease) that was placed to remove the 100% blocked artery, restoring normal flow to the heart. He was looked after by multi-disciplinary critical care team; the ECMO support was removed after 3 days and indeed to everyone’s surprise this young man sprung back to normal conscious state with no trace of brain defect or paralysis” Later after 4 days he suffered another heart attack at midnight hours which was also successfully treated with another angioplasty and his heart function recovered from initial 20% to the normal 55%. This young gentleman walked back home after a medical miracle or indeed a resurrection.
This scenario is extremely rare and quite challenging to cardiologists and emergency care physicians - as every second delayed will lead to brain damage where the patient will remain in a state of coma for rest of his life or die.
Mr.MS was likely in state of suspended animation which could possibly explain his zero brain injury according to Dr Manoj Sivaramakrishnan. (What invoked this suspended animation is not clear, but certainly to his good destiny and luck). He says this case scenario highlights timely effective resuscitation and ECMO support - eCPR – which is central and crucial in managing victims of cardiac arrest. None should be sent away without initiating life support resuscitation when brought to hospital facility with short period of unresponsiveness even with no signs of life.
Symptoms of Sudden Cardiac Arrest
• Sudden collapse
• Loss of consciousness
• No pulse
• No breathing
• Preceding history of Chest pain
• Preceding Extreme weakness or exhaustion
• Preceding history of fast heart beating, fluttering or pounding (palpitations)
Action to be taken
• Immediately Call the ambulance service or urgently move the person to the nearest hospital
• Perform CPR / eCPR, if you
Kauvery Hospital always offers 24 x 7 ECMO services and in this case with emergency advanced medical interventions and ECMO support, we were able to achieve success bringing him back to normal life with zero brain damage or neurological complications," he adds. In India, 10 % of deaths occur due to sudden cardiac arrests. Out of hospital cardiac arrest has bleak survival of <5%. The need for AED – Automated External Defibrillator should be a mandatory requirement in all community places like restaurants, hotels, worshipping places, parks, recreation centres, travel stations etc. These are usual norms in developed world.
Speaking about the successful treatment, Dr Manivannan Selvaraj, Founder and Managing Director, Kauvery Group of Hospital says "More awareness needs to be created on responding to sudden cardiac arrests. Lot of them do not know what should be done and they end up losing their near and dear ones. It is very critical to contact an ambulance service or commute to the nearest hospital to get the required medical intervention within the stipulated time. This unique case of cardiac arrest is a benchmark in the field of medicine and such degree of treatment can be performed only with high expertise and adequate infrastructure. I congratulate Dr S Manoj and team for helping the patient regain his life with zero complications."
Please join me to wish this 27years gentleman a cheerful, beautiful, healthy and long family life on his rebirth. This case management depicts a very unusual but a WE CAN DO IT – treatment strategy faced with worst clinical adversities. This reminds me of Swami Vivekananda’s most meaningful words “YOUR EFFORTS MAY FAIL, BUT DO NOT FAIL TO MAKE EFFORTS”
We had put all our resources at KAUVERY HOSPITAL most effectively in this clinically indicated life threatening case scenario. I would like to place my sincere thanks to a committed multi-disciplinary team involved ER consultant - Dr.Niventhini Thangaraj; ER post graduates Dr.Jothimeena, Dr.Sanjana, Dr.Sam along with our ER staff Ms.Vanilla, Mr.Mani, Mr. Parthiban, Ms. Sukanya, Mr.Tamilvanan; our most efficient Paramedics Mr.Naveen, Mr.Balaji, Mr.Sukanya and our always reliable CT Anesthetist team Dr.Arun, Dr. Hari, Dr. Shiva and Dr. Chandrasekar with a deeply committed Senior Perfusionist Thiru.Murugadoss, and junior perfusionist Mr.Damodharan who effectively looked into the post PCI ECMO assist. I also wish to thank and our Cath lab personnel Ms.Sinimol, Mr.Emanuel, Mr.Tamilselvan, Mr.Devigan and Mr.Dharan and Dr.Senthil in CCU along with our CCU staff Ms.Akila, Ms.Jayapriya, Ms.Pushpa, Ms.Kalaimathi and Ms Pooja for their dedicated critical care nursing support. I also thank Dr.Yamini Kannapan for her most valuable counselling for the rebirth life of this young gentleman.
This case also illustrates well our abilities and optimal resource utilization in such dire emergencies; we position ourselves as a pioneer in e-CPR and have develop a wholesome team to be activated at all times, towards such life saving strategies.
Dr. Manoj Sivaramakrishnan
Senior Consultant & Interventional Cardiologist
Kauvery Hospital, Chennai