Apollo Hospitals said this evening that a team of its doctors and those from AIIMS were continuously monitoring the health of CM Jayalalithaa and denied as "totally baseless and false" reports that she was no more.
Apollo Hospitals said this evening that a team of its doctors and those from AIIMS were continuously monitoring the health of Chief Minister Jayalalithaa and denied as "totally baseless and false" reports that she was no more. "Some TV channels are wrongly reporting that the Honourable CM is no more. It is totally baseless and false. They are advised to rectify this mistake based on this press release," the hospital said in a statement after news channels reported that the AIADMK leader was no more.
With the health of Tamil Nadu Chief Minister J Jayalalithaa deteriorating, party MLAs are scheduled to meet later this evening apparently to chalk out the next course of action. Earlier in the day also the AIADMK MLAs had met at Apollo Hospital, where Jayalalithaa is undergoing treatment, and reportedly discussed the leadership issue among other matters.
Though party sources did not reveal the agenda of the meeting scheduled in the evening, they, however, confirmed that the legislators would discuss key matters. According to doctors, the condition of Jayalalithaa, who suffered cardiac arrest, is very "grave". AIADMK has a total of 136 MLAs in the 234-member House, including Jayalalithaa, who represents Dr Radhakrishnan Nagar here.
Sixty-eight-year-old Tamil Nadu supremo Jayalalithaa is wired up from head to toe inside the High Dependency Unit of private-run Apollo Hospital in Chennai. After she is said to have suffered a cardiac arrest on December 4 evening, she was transferred on Extra Corporeal Membrane Oxygenation (ECMO) machine.
Dr Richard Beale, Intensivist at London Bridge Hospital who had been monitoring her condition said in a written statement, “She had been doing well. Inspite of the progress she was making, her underlying health conditions inevitably meant that the risk of further problems always remained. She is now on extra corporeal life support.”
Outcomes of patients on ECMO are poor, said Dr Ramakant Panda, Cardiac Surgeon who had operated on Ex-Prime Minister Manmohan Singh in 2009. “Even if a person recovers it may take weeks, we cannot expect a miraculous overnight change in the patient’s condition.”
ECMO explained
A sudden cardiac arrest can occur due to multiple reasons, say doctors. “Her lungs had already been compromised, as a result the heart may have weakened. It could be a result or an infection. It could also have been a result of electrolyte imbalance, which leads the levels of Potassium to peak in the body causing an arrest,” said a senior Cardiologist requesting anonymity.
In an ECMO procedure, huge cuts are made in the groin area and two thick pipe-like tubes are inserted inside to flush out and pump recycled blood back inside. ECMO machine consists of a pump which mimics the heart and lungs.
An endo-tracheal tube is attached along with the ventilator to aid breathing. Leads are attached on chest to monitor heart rate. A line is inserted inside the arm to check on blood pressure. Patient is also put on dialysis and special leads are attached on the head to monitor brain functioning.
When the pumping of heart is compromised, organs like kidney, liver and brain may suffer damage and fail. ECMO takes over the heart and lung function, giving them time to heal.
“One must understand that ECMO is a support system and not a treatment modality. The machine takes blood out of the body, oxygenates it and returns it back to the body.
As ECMO takes on the burden of performing the functions of heart and lungs, it gives temporary rest to the wounded organs to recover. At times patients, even old ones do get revived on ECMO,” said Dr Sandeep Dewan, head of department, Critical Care at Fortis Memorial Research Institute.
Doctors said that even when the heart completely collapses, but the patient is put on ECMO within a few minutes, there are chances of revival of the heart over a few days. While in US and Europe, where technologies have advanced of all patients put on ECMO, upto 56% of them bounce back, in India, the survival rates hover between close to 40%.
The entire procedure of wiring a patient up for ECMO and fixing the circuit costs upto Rs 3.5 lakhs. Additionally, each day that a patient is on ECMO costs Rs 10,000. It is the last resort for a patient when ventilator support and drugs fail. Dr Dewan has treated 25 patients on ECMO in the past one and a half year of which ten have survived.
Jaya illness timeline:
September 22 - Jayalalithaa hospitalized and it is maintained that she is recovering
October 2 - Dr Richard Beale is flown in from London to advise on her respiratory distress due to infection in lungs
October 6 - A team from All India Institute of Medical Sciences in New Delhi is flown in
October 7 - It is announced that she is on respiratory support, on nebulisation and antibiotics
October 21 - It is noted that she is sitting up and is recovering well
November 19 - She is shifted to a private room and is said to be responding well without ventilator support
December 4 - Earlier in afternoon, AIIMS doctors say she is good to go home, but later in evening suffers cardiac arrest
December 5 - She is put on ECMO life support, after having tried cardio-pulmonary resuscitation for close to 40 minutes.
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