​Saved From Deadly Infection

ECMO: A key life-saving treatment technique

PULSE Issue 41 | July 2023

For more than 60 days, 17-year-old Dante Lin fought for his life relying on the Extracorporeal Membrane Oxygenation (ECMO) life support. In June 2022, Mr Lin experienced severe pain in his knee and was admitted to the National University Hospital (NUH). Unexpectedly, his condition rapidly deteriorated over the next 12 hours. He fell unconscious and his oxygen levels dropped so low that he was on the verge of a cardiovascular collapse. He was not responding to any treatment and was on the brink of death. With no other viable options, the medical team from NUHCS' Cardiothoracic Intensive Care Unit (CTICU) quickly put him on ECMO to sustain his life. From then, a multidisciplinary team comprising healthcare professionals from both NUHCS and NUH kept a close watch on Mr Lin’s condition, adjusting his treatment accordingly.

“It was highly likely that Mr Lin would have died that same night had he not been stabilised with ECMO,” said A/Prof Graeme MacLaren, Director, Cardiothoracic Intensive Care Unit (CTICU) and Senior Consultant, Department of CTVS, NUHCS. He was also the lead on Mr Lin’s medical team. 

Typically, patients only need ECMO for one to two weeks. Mr Lin was the first such patient at NUH who depended on ECMO life support for much longer. In total, he spent 62 days on ECMO and 98 days in the CTICU. While in CTICU, he had good days and bad, experiencing multiple life-threatening situations. At one point, the medical team had to put him on three different types of ECMO as no air could go in or out of his lungs. For two whole months, Mr Lin remained unconscious while the ECMO machine took over the bodily functions of his heart and lungs. Connected to the equipment by a number of tubes, wires and cables, his medical team monitored his condition closely, frequently adjusting the amount of support he required. Eventually, he woke up and slowly regained his strength, weaning off the ECMO life support in stages. His heart and lungs managed to stabilise, and he could finally return home on 26 Sep 2022.

Doctors discovered that Mr Lin’s knee pain had been triggered by a bacteria, “golden staph”, infection. The bacteria entered his bloodstream and spread quickly to his lungs, which later induced a severe septic shock. Septic shock is a life-threatening condition when blood pressure falls to dangerously low levels during an infection. The use of ECMO in septic shock cases is extremely rare, even in the world’s busiest ECMO centres.

Nonetheless, Mr Dante Lin had survived his ordeal against all odds. A/Prof MacLaren said, “ECMO is essentially a heroic form of life support, used only for the sickest patients in whom no other treatment has worked and without which they would otherwise die. ECMO use is increasing worldwide, in part because of the COVID-19 pandemic, but also because clinicians are becoming more skilled at using it.”