24/7 advanced extracorporeal life support and intensive care pulmonology for catastrophic acute respiratory distress syndrome (ARDS), refractory hypoxemic respiratory failure, and massive pulmonary embolism. Specializing in Veno-Venous (VV) ECMO, mobile inter-hospital retrievals, and bridging to recovery or lung transplantation at KIMS Super Speciality Hospital, Electronic City, Bangalore.
High-precision diagnostics, cutting-edge medical technologies, and evidence-based treatment pathways tailored for individual patient outcomes.
Extracorporeal Membrane Oxygenation (ECMO) is the ultimate life-support technology utilized when conventional mechanical ventilators can no longer maintain safe oxygenation or carbon dioxide clearance without causing fatal ventilator-induced lung injury (barotrauma and volutrauma). By temporarily routing venous blood through an external artificial membrane lung, ECMO oxygenates the blood and removes carbon dioxide, giving the severely damaged native lungs complete physiological rest.
The Thoracic Critical Care & ECMO Service provides 24/7 extracorporeal life support for refractory acute respiratory distress syndrome (ARDS) and life-threatening hypoxemic failure. Clinical capabilities include bedside percutaneous cannulation for Veno-Venous (VV) and Veno-Arterial (VA) ECMO, ultra-lung-protective ventilation, awake mobility protocols, and dedicated 24/7 mobile retrieval teams.
Recognizing clinical signs and diagnostic triggers that indicate the need for specialized pulmonary review.
Persistent arterial hypoxemia despite optimized mechanical ventilation with 100% oxygen (FiO2 1.0), high PEEP, neuromuscular blockade, and 16 hours of prone positioning.
Catastrophic carbon dioxide retention and life-threatening acidemia despite maximal safe minute ventilation, threatening cardiac arrest and hemodynamic collapse.
Inability to ventilate without exceeding safe plateau pressures (> 30 cmH2O), risking severe barotrauma, pneumothorax, and ongoing ventilator-induced lung injury.
Rapidly progressive bilateral pulmonary consolidations ("white-out lungs") secondary to influenza (H1N1), severe viral pneumonias, aspiration, or severe systemic sepsis.
Catastrophic saddle pulmonary embolism causing acute right ventricular failure and cardiogenic shock requiring immediate VA-ECMO support or catheter embolectomy.
Sudden respiratory failure in a patient with end-stage lung disease awaiting donor organs, requiring urgent VV-ECMO as a bridge to lung transplantation.
Advanced medical and surgical equipment providing high-yield diagnostic precision and life-saving therapeutic interventions.
Large-bore dual cannulation (femoral-jugular or single dual-lumen bicaval cannula) draining deoxygenated venous blood to an external centrifugal pump and polymethylpentene membrane lung, returning oxygenated blood to the right atrium.
Venous blood is extracted from the right atrium and returned directly into the arterial arterial tree (femoral artery) under high pressure, providing comprehensive full-body circulatory perfusion alongside oxygenation.
A specialized flying/road critical care squad equipped with portable ECMO consoles, point-of-care ultrasound, and ICU ventilators that travels to referring regional hospitals, performs bedside cannulation, and safely transports the stabilized patient to KIMS.
Avoiding deep continuous sedation and paralytics once stable ECMO flows are established. Patients are extubated while on ECMO, allowed to communicate with family, eat oral nutrition, and sit out of bed or walk with physical therapists.
Lower blood-flow extracorporeal circuit (400-1000 mL/min) dedicated primarily to efficient CO2 elimination in severe acute hypercapnic respiratory failure (severe COPD exacerbation or moderate ARDS).
Minimally invasive bedside tracheostomy performed under direct real-time flexible bronchoscopic guidance in the ICU, providing secure long-term airway access with near-zero bleeding risk.
How we guide every patient from initial assessment to definitive treatment and long-term functional recovery.
Immediate 24/7 phone consultation with referring intensive care team, reviewing PaO2/FiO2 ratio, ventilation pressures, Murray lung injury score, and reversibility.
Percutaneous ultrasound- and fluoroscopy-guided insertion of large-bore heparin-coated cannulae into femoral and jugular vessels, with immediate extracorporeal flow ramp-up.
Ventilator settings immediately dialed down to "lung rest" (PEEP 10-12, driving pressure < 10, low rate), stopping ventilator barotrauma while the membrane lung sustains life.
Serial monitoring of native lung compliance, chest radiography, sweep-gas weaning trials, and safe bedside decannulation once native gas exchange recovers.
Clear, clinically accurate answers to common patient questions regarding this pulmonary specialty.
A regular mechanical ventilator forces air and oxygen under positive pressure into your natural lungs through a breathing tube in your windpipe. When lungs are severely damaged and stiff, high ventilator pressures can cause further physical tearing and lung injury. ECMO bypasses the lungs entirely: it takes dark venous blood out of your body, runs it through an artificial lung machine that adds oxygen and removes carbon dioxide, and returns bright red blood back into your bloodstream, allowing your injured lungs to rest and heal.
Patients can be safely maintained on modern biocompatible ECMO circuits for several days, weeks, and in specialized cases (such as bridging to lung transplantation or severe ARDS recovery), for several months. Our team rigorously monitors anticoagulation, circuit performance, and infection prevention around the clock.
Severely hypoxemic patients with advanced ARDS are too unstable to be transported in a regular ambulance to Bangalore because standard transport ventilators cannot maintain their oxygenation. With Mobile ECMO, the specialized team travels with a portable ECMO machine directly to the patient’s local hospital, connects them to ECMO at their bedside, stabilizes them, and safely transports them back to KIMS Hospital.
Because blood circulates through artificial plastic tubing, continuous blood-thinner medication (heparin or bivalirudin) is required to prevent clotting, which carries a risk of bleeding. Other potential complications include localized infection at cannula sites, vascular complications, and platelet consumption. These risks are minimized through dedicated 1:1 ICU nursing and round-the-clock intensivist monitoring.
ECMO is not a last resort for hopeless cases; it is a life-saving temporary rescue bridge for patients with potentially reversible acute lung failure. When initiated in a timely manner (before multi-organ failure sets in), modern international registry data and our center’s experience show survival rates of 65-75% in severe viral and bacterial ARDS, with patients returning to full, active lives.
Consultation Specialty: Critical Care & ECMO
