MY AUNTY IS IN INTENSIVE CARE ON ECMO FOR ARDS, WE’RE VERY WORRIED SHE MAY DIE! HELP! (PART 5)

Published: Mon, 07/20/15

Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we INSTANTLY improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question last week was PART 4 of

”MY AUNTY IS IN INTENSIVE CARE ON ECMO FOR ARDS, WE’RE VERY WORRIED SHE MAY DIE! HELP!" (PART4)

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another question from one of our readers and the question this week is PART 5 of

"MY AUNTY IS IN INTENSIVE CARE ON ECMO FOR ARDS, WE’RE VERY WORRIED SHE MAY DIE! HELP!" (PART 5)

Lee from the UK writes

Hi Patrik,

today my aunty’s oxygen levels have been reduced to 45% oxygen.

They have removed the Tracheostomy and put a breathing tube back into her mouth instead.

They said it was because the Tracheostomy had a leak which was causing oxygen levels to go up higher for more support.

The doctors spoke about a mini- ecmo and they also said that the cons outweighs the pros, because of something to do with platelets and it doesn't seem as if today they had drained much more fluid off at the minute.

They won't consider ECMO as they said she is not at that stage yet, but surely if the lungs are not drying out more, she’ll be back on ECMO rather sooner than later to enable more time for rest and to heal her lungs!

Thanks Lee

Hi Lee,

that's very unusual to go from Tracheostomy back to the tube in the mouth and if the leak in the Tracheostomy caused the increased oxygen demand then they obviously have found the reason for it.

Leaks in tracheostomies can happen but are very rare.

As long as it fixed the problem that's the main thing.

45% oxygen requirement sounds a lot better than 65% oxygen and as a rule of thumb, anything above 50% oxygen is concerning.

And besides, 45% oxygen requirement doesn't indicate the need for ECMO.

I can only emphasize again, that things in Intensive Care move slowly, especially when things are improving, it's often slow and almost invisible for families.

The main goal at the moment is to keep your aunty away from the ECMO and it looks like she is holding her own at the moment.

Just sit and wait, that's all you can do.

And always keep in mind, yes you want your aunty going back on the ECMO if need be, however the goal is to keep her off the ECMO and get her lungs to heal without it.

I don't know why they stopped the dialysis machine for now and it could well be that they've taken enough fluids away for now, especially if her kidneys are working.

And if your aunt has low platelets, it would be a risk indeed to get her back on ECMO. Low platelets cause bleeding and any procedure with cannulas, like the ECMO cannulas would have a high risk involved with low platelets.

If your aunty needs ECMO again, they would have options to transfuse her FFP's(Fresh frozen plasma) and Platelets prior to inserting ECMO as it increases the number of Platelets.

However once on ECMO they almost always use Heparin(a blood thinning drug) to stop blood clots in the ECMO circuit.

It's one of the biggest challenges when using ECMO to get the balance right between not bleeding and not having the blood clot. Either scenario could have devastating consequences.

Therefore, if your aunt can stay off the ECMO, it's all the better.

Stay positive, it sounds like your aunty is making slow progress. And always keep in mind that things don't improve quickly in Intensive Care, let's look at the small and positive signs and take it day by day.

Keep me in the loop and I'll guide you.

Your friend

Patrik Hutzel

Skype ID patrik.hutzel

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