THE National Kidney and Transplant Institute (NKTI) said on Monday it is spending around P16 million to purchase two more units of Extracorporeal Membrane Oxygenator (Ecmo), a technology used in the management of pulmonary hemorrhage in leptospirosis, ahead of a spike in cases of the flood-borne disease, since the rainy season is not over yet.
In an interview after a press briefing at the hospital’s diagnostics center in Quezon City, NKTI Executive Director for Administration Dr. Rosemarie Liquete told the BusinessMirror they received from the Department of Health (DOH) the fund to buy this equipment.
“So, hopefully, in two months, we can purchase them,” she said, adding that the first Ecmo machine, which was also financed by the health agency, was delivered to the hospital last May.
Since June of this year, when the DOH declared an outbreak of the deadly infection in Metro Manila, four patients with pulmonary hemorrhage and kidney failure admitted to NKTI have been treated successfully with this German technology for free.
“Rather than ending up with end-stage kidney disease, [or undergoing] dialysis for life, [leptospirosis] is a disease that can recover. It’s good that we give our finances to the needy for their recovery,” said Dr. Romina Angangco Dañguilan of the nephrology division at NKTI.
Ecmo is a machine where blood is oxygenated extracorporeally. It enables adequate respiration while the patient’s lung is allowed to recover through mechanical ventilation at lung rest settings.
“We are happy this technology is now with us,” Ecmo Medical Team Head Dr. Joselito Chavez said in Filipino.
He described it as “trailblazing” because it gives leptospirosis patients a chance to survive and go back to their normal lives.
Leptospirosis, known in most countries as a rare disease, is endemic to the Philippines.
It is spread to humans through contact with urine of infected animals like rats or through contact with water or soil contaminated by infected animals.
Wading in floodwaters is one of the many ways by which people are infected by this dreaded illness.
Globally, 20 percent to 70 percent of people affected with such zoonotic bacterial disease experience pulmonary complications, and their chances of survival is slim.
The mortality rate of leptospirosis patients in most countries averages from 3 percent to 20 percent, majority of deaths due to pulmonary hemorrhage.
However, in the Philippines, it now stands at 15 percent. In NKTI alone, a total of 364 leptospirosis cases have been recorded since June 2018—55 of them died.
“We’ve been studying it through the years ,and we have changed our protocol,” said Dr. Danguilan. “We’ve been able to lower the mortality. Where before, it was about 25 percent to 30 percent, it’s now down to about 15 percent.”
While scientific literature and studies reveal that there have been five to six patients treated with the Ecmo machine worldwide, there are already four Filipinos who have successfully survived through this innovation.
“So we can say that it’s really trailblazing. We have the highest [number of successful cases] in two months to use this [machine]. It’s really good because they’re still alive,” said Dr. Chavez, who also serves as the deputy executive director for medical services.
Currently, NKTI attends to 12 leptospirosis patients confined in the hospital’s gym that has been converted as an alternative ward since the outbreak in June.
The hospital has already sent a letter to PhilHealth, requesting for the coverage of Ecmo treatment, which more or less is priced at P2 million.
“If they will cover at least P800,000 of the cost, it will really be of big help,” Dr. Liquete said, while citing that they are bullish on the positive response yet from the state health-insurance arm. “Because we all know that not all of the expenses can be paid for by the government, we can also use the funds of NKTI.”