Only two ECMO machines to treat COVID-19 patients in Sri Lanka; MoH looking to acquire more

ECONOMYNEXT – Sri Lanka has is looking to acquire more Extracorporeal Membrane Oxygenation (ECMO) machines to treat COVID-19 patients that suffer severe symptoms, an expert said.

Prof P T R Makuloluwa, senior Lecturer in Anaesthesia, Faculty of Medicine, told EconomyNext that the Ministry of Health (MoH) is currently studying avenues to acquire the machines for hospitals that treat COVID-19 patients.

“We had a discussion with the ministry and Director of Health Services Dr Asela Gunawardena regarding this. Once we do get the machines, it is important to have trained staff to operate them as well,” Makuloluwa said.

At present, Sri Lanka has two ECMO machines: one at the Lady Ridgeway Children’s Hospital (LRCH) and the other at the Karapitya Teaching Hospital in Galle. The machine at LRCH has not been used for over a year, hospital sources said.

According to the University of California’s website, the ECMO machine is similar to the heart-lung by-pass machine used in open-heart surgery and pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest. When a patient is connected to an ECMO, blood flows through tubing to an artificial lung in the machine that adds oxygen and takes out carbon dioxide. The blood is then warmed to body temperature and pumped back into the patient’s body.

Dr Gayan Danthanarayana who passed away yesterday at the Karapitiya Teaching Hospital due to COVID-19 was connected to the ECMO machine at the hospital. Deputy Director General Health Services Dr Hemantha Herath told EconomyNext today that, despite this, the patient did not survive due to the severity of his condition.

Prof Makuloluwa, who is also Consultant Anaesthetist at Kotelawala Defence University (KDU) Hospital, meanwhile, said that MoH officials had declared their intention to divert the machine at LRCH to a hospital that treats COVID-19 patients.

LRCH Director Dr G Wijesuriya, however, said even though the machine had lain dormant for some time, no request had been made to divert it to another hospital to treat COVID-19 patients.

“So far it has not been used during my stay at the hospital, and no one has made a request for the machine either,” Wijesuriyia told EconomyNext.

The ECMO machine can be used to support COVID-19 patients who suffer from pneumonia and face difficulties in breathing. Countries such as Vietnam started deploying ECMO machines throughout their hospital network to oxygenate the blood of elderly COVID-19 patients who cannot be saved with mechanical ventilators.

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Pediatric surgeon Dr Cethan Sathya writing to the Washington Post in April last year said that though the machine has kept patients alive in the US, the procedure is a resource-intensive, costly and risky treatment with many complications.

“It may only improve survival for a small number of COVID-19 patients — though the data is limited. So this raises the question: Should we be adopting widespread use of ECMO for COVID-19 patients when our health-care system is struggling with a lack of simpler resources?” he wrote. (Colombo/ Feb02/2021)

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