The actor Paulo Gustavo, hospitalized on behalf of Covid-19 since March 13, showed a worsening in his health, this Friday (2). According to his team’s medical record, the comedian needed to undergo therapy called ECMO
(Extracorporeal Membrane Oxygenation).
ECMO can be used on people of all ages, from newborns to the elderly, and makes it possible to replace the activity of only the heart or lung.
But what is this treatment?
ECMO is an artificial heart and an artificial lung
for the patient, who uses a circuit of tubes, pump, oxygenator and heater that is installed outside the body. Because of the complications of patients with Covid-19, the use of the technique has increased among the most serious patients to spare these organs while healing takes place.
In an interview with iG, Luiz Guilherme Velloso, a cardiologist at the São Camilo de São Paulo Hospital Network, explained how ECMO veno-venosa
it works. “It is a technique in which blood is removed from the body and pumped out of the body through a vein. The blood passes through a pump and an extracorporeal oxygenation membrane, where it eliminates carbon dioxide and is oxygenated, which would be the function of the lung. After passing through this membrane, it is reinjected into the body, properly oxygenated and free of carbon dioxide “.
It can be used in the postoperative period of cardiac surgery, severe lung diseases, heart failure, trauma or severe infection, among others.
According to the doctor, the average time of treatment with artificial lung in more severe patients is five to seven days. As he is younger, the cardiologist says that the chances of recovery from actor Paulo Gustavo
are great. “A younger body with no associated diseases has more weapons to fight such a serious form of Covid.”
What are the risks and benefits?
The cardiologist explains that it is not a simple procedure. “Like any complex procedure, there are risks, ranging from bleeding during ECMO maintenance, blood thrombosis during the journey and infection. Anyway, it is a technique that involves great complexity”, warned the specialist.
But, the doctor points out that when the health team decides to use ECMO, it is because the benefits outweigh the risks of a complex operation. “There are situations in which the artificial ventilator cannot offer sufficient oxygenation to maintain the patient’s life. In these cases, when the lung is extremely compromised, it is an expected maneuver to keep oxygenation compatible with the individual’s life”, he says.
The cardiologist also guarantees that the technique is important in severe cases of Covid-19. “This makes sense because the Covid-19 inflammatory pneumonia reaches its peak and then slowly regresses with the treatment, we can gain up to four days for the patient to start improving from that health condition. Maybe without that, he would not have enough time to recovery “, he explained.
What is the difference from ECMO to a respirator?
Luiz Guilherme Velloso points out that when the lung suffers an infectious, inflammatory or traumatic injury, it has compromised its function, which is basically to oxygenate the blood and remove carbon dioxide to allow the organism to function properly. “For lungs with little damage, the artificial respirator is often the solution for the organ to improve. In some cases, artificial ventilation with an amount of oxygen greater than that of the atmosphere may be sufficient”, he explains.
More, it is to lung injury
more severe and more intense, the need for greater amounts of oxygen supplied by the respirator becomes necessary. “When the respirator technique is not enough to maintain tissue oxygenation to maintain life, then the use of ECMO is considered. That is the difference, the severity of lung injury”, says the cardiologist, emphasizing that in 2021, at the São Camilo Network, about 20 patients with Covid-19 went to ECMO. Survival was around 30%, compatible with that observed internationally.
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