Awake Proning and High-flow nasal cannula (HFNC) are the

Awake Proning and High-flow nasal cannula (HFNC) are the Game Changers in Covid Treatment that Help Cure Patients      

Apollo Speciality Hospitals, Vanagaram was one of the first hospitals in Chennai to step up and treat COVID patients in the private sector. An exclusive fever clinic at the hospital has treated over more than thousand patients. Apollo Speciality Hospitals Vangaram has saved many lives with HFNC and Awake Proning eliminating the need for ventilation.

Many COVID patients are profoundly Hypoxemic with low oxygen saturation- a condition called “Silent / Happy Hypoxia”. They will be completely normal and comfortable with no breathing difficulty, however, their oxygen level will be deteriorating at a faster pace. This can be picked up only by pulse oximeter. These patients really do well with oxygen supplementation alone.

With progression of the disease some of these patients with “Silent Hypoxia” become more hypoxic in spite of oxygen supplementation. This is where we have seen the results of “Awake Proning”. In any patient requiring more than 4 litres oxygen an awake proning protocol is employed. This simple non-invasive technique can eliminate the need for ventilation in some Covid-19 patients. “Awake Proning” is basically having patients turn over onto their stomach or onto their side while lying down. This method has been remarkably effective in boosting the “Blood Oxygen Saturation” levels in the covid patients who have silent Hypoxia.

Based on observation at Apollo Hospitals Vanagaram, the results are so encouraging in people with both silent Hypoxia and severe Hypoxia said Dr. Ebenezer, Senior Consultant and ICU Incharge “When the patients lie on the back, the fluid in the lung in Acute Respiratory Distress Syndrome accumulates in the bottom of the lung, the heart and other abdominal contents further compress the lung region leading to non-uniform ventilation. When proning is done the patient’s body is parallel to the ground, this flipping over will give more room to the lungs without any compression. Awake Proning eliminates the need for intubation and ventilatory support in some patients”

He also added, “Some patients with a severe disease become progressively hypoxic at the same time breathless requiring some form of support and assistance for which we use a High Flow Nasal Cannula or a non-invasive ventilator. In these patients also we employ awake proning to help us tide over the crisis and offset the hypoxemia.”

Below are details of few patients on who both Awake Proning and HFNC were used:

·         65yr old gentleman with coronary artery disease and H/O spine surgery had severe covid pneumonia. His CT severity index on admission was 26 and he became progressively hypoxic. We tried NIV but he was not tolerating, on employing HFNC with awake proning he beautifully settled down, A team of ICU technicians and nurses diligently worked on the protocol. Finally after two weeks of stay in ICU he was weaned off HFNC and walked home safely.

                               

·         40 yr old diabetic patient was admitted with severe hypoxemia, admission CT scoring was 33, was treated effectively with HFNC/NIV and awake proning we were able to avoid intubation. Once we explained in detail the protocol and sought the cooperation of the patient we were surprised by his willingness to strictly adhere to the protocol. Constant motivation and encouragement from his family was a force multiplier.

        

 ·         72yr old DM with underlying COPD admitted with very bad lungs, severely hypoxic was initially managed with NIV and routine supportive treatment. Subsequently he became breathless and was intubated and placed on ventilatory support.after a prolonged stay on the ventilator he was successfully weaned and extubated, discharged after forty days in hospital proving that age is after all a number.

·         65yr old with no comorbids shifted from another hospital with severe respiratory distress COVID positive was subsequently intubated and ventilated. Patient required prolonged periods of paralysis and sedation. He was on LMWH. On stopping sedation paucity of movement noticed on left side. Shifted for CT brain, Right MCA territory infarct noted. Neurologist opinion obtained and treated appropriately. He started spiking fevers became hypotensive requiring vasopressors ,blood cultures grew MDR Acinetobacter, treated with colistin, survived septic shock. Slowly patient was weaned and extubated. Neuro-rehabilitation was provided and patient is ready for discharge.

·         39 yr old patient with admitted with C/O fever,cough and breathing difficulty with a CT severity of 33,got intubated for worsening hypoxia and was successfully weaned and extubated.He was treated with steroids, LMWH and Tocilizumab. He was a young individual who responded very well to invasive ventilatory support based on tried and tested ARDS ventilatory protocol.

Happy hypoxemia is a true phenomenon, HFNC and awake proning is a game changer and where there is a need there should be no hesitation no dilemma in instituting invasive ventilator support. Across the globe sick COVID pneumonia patients did not die because they were ventilated rather they died on the ventilator due to the disease per se and in many instances many lives were lost because of absolute lack of ventilators. As the war against COVID intensifies Apollo Speciality Hospitals Vanagaram will continue to be a beacon of hope for the sick and suffering in and around Chennai.

Fortis Malar Hospital celebrates International Women’s Day

On the occasion of International Woman’s Day, Fortis Malar Hospital today organized a health and entertainment event for their nurses and patients along with the doctors at the hospital permises. 

The event focused on creating awareness on the need for women to listen to their bodies, protect their heart and maintain overall wellness in their daily lives.  

Dr. Madhu Sankar N Senior Consultant & HOD - Cardiothoracic & Vascular Surgery, Heart & Lung Transplant, Fortis Malar Hospitall, Dr. Anto Sahayaraj R, Senior Consultant Cardiothoracic Surgery, Fortis Malar Hospital and Dr. Nithya Ramamurthy, Senior Consultant, Gynaecology, Fortis Malar Hospital addressed the gathering. 

Fortis Malar Hospital celebrates International Women’s Day with Nurses and Patients

·        Emphasizes on the need for awareness among women regarding cardiac related ailments

·        An exclusive activity was organized to make their women feel special and beauty, both on the inside and outside

On the occasion of International Woman’s Day, Fortis Malar Hospital today organized a health and entertainment event for their nurses and patients along with the doctors at the hospital permises. The event focused on creating awareness on the need for women to listen to their bodies, protect their heart and maintain overall wellness in their daily lives. Dr. Madhu Sankar N Senior Consultant & HOD - Cardiothoracic & Vascular Surgery, Heart & Lung Transplant, Fortis Malar Hospitall, Dr. Anto Sahayaraj R, Senior Consultant Cardiothoracic Surgery, Fortis Malar Hospital and Dr. Nithya Ramamurthy, Senior Consultant, Gynaecology, Fortis Malar Hospital addressed the gathering.

Studies have shown that there has been a steady increase in cardiac related ailments among women in the recent years. In an attempt to address this growing trend, Fortis Malar Hospital hosted an awareness secession as part of their International Women’s Day 2020 celebrations. The session educated and encouraged women on various aspects of wellness, especially on cardiac well-being. As women are indispensable to the environments they live and work in, it is important for them to cultivate a habit of self-care, a critical routine that almost every woman puts off as a last priority.

Commenting on the activity, Dr. Madhu Sankar said “We are extremely delighted to have organized this activity in order to celebrate the significance and salute the excellence and spirit of women. When compared to men women seem to pay very less attention to their health. Cardio Vascular Disease has been considered since times immemorial to be a man’s domain and there is a notion that women are relatively protected from it but studies have proved that CVD is the major cause of death among women.  Hence its important that women also take regular health checkup and maintain a healthy lifestyle.”  

As a part of the celebrations Fortis Malar Hospital in collaboration with premier beauty salon Green Trends conducted an exclusive makeover activity to make participating women feel special and good. This activity was aimed at providing grooming experience for nurses and other women staff who are working round the clock for the patients and hardly have any time for themselves. The event acknowledged the contributions of women to Fortis Malar Hospital’s success and recognized their dedication and relentless hard work in the care of the ailing.

 

Dr. Rela Institute & Medical Centre launches Rela Heart Beats

Dr. Rela Institute & Medical Centre launches 'Rela Heart Beats'

* Pioneering cardiac support group of Dr. Rela Institute

* Unique initiative by patients, for patients

Dr Rela Institute & Medical Centre (RIMC), a Multi-Speciality Quaternary Care Hospital at Chromepet in Chennai, was established with a vision to provide outstanding clinical care with integrated and highly qualified medical professionals, who are equipped with state-of-the-art infrastructure.

A pioneer in providing comprehensive, multidisciplinary and specialized services for all major specialties in the country, it is known as one of the most scientifically advanced hospitals in India with a multi-disciplinary team of Surgeons, Intensive care, specialised in adult and pediatric care under the able leadership of Prof. Mohamed Rela, Chairman & Managing Director at RIMC, who himself is a world renowned liver transplant surgeon. Soon, RIMC will start heart transplants too.

 Today, Rela Institute's Department of Cardiac Sciences has launched the institute’s Pioneering Cardiac Support Group “Rela Heart Beats”. Popular film actor, director and producer Thiru. Cheran was the chief guest of the occasion. He lauded Prof Mohamed Rela, Chairman & Managing Director, Rela Institute for the initiative and also for providing best care to patients.

An excellent initiative by the patients and for the patients, Rela Heart Beats Support Group is as varied as the people in them. It's primarily a community of all the brave heroes who have emerged out of the heart related health difficulties and are now happy to lead a normal life and enjoy their health, family, work and other things.

Dr. Balamurali Srinivasan, Senior Consultant & Clinical Lead in the Department of Cardiac Sciences, DrRela Institute & Medical Centre, said, "An intiative for supporting patients in their rehabilitation, this platform offers a chance to all the members of support group to share their experiences in a friendly and mutually supportive environment. It provides a wide range of other benefits and connects the team together. RIMC also welcomes all other people who have undergone similar journey with free membership in our Cardiac support group."

Dr. V Narendra Kumar, Senior Consultant, Interventional Cardiology, Heart Failure and Transplant Cardiology in the Department of Cardiac Sciences said, "This gives an opportunity to make new friends and have a sense of fellowship among the people who have gone through similar life experiences. This get-together keeps them fit and updated and builds confidence back to get on life."

Dr. Kamalakannan, Consultant, Anaesthesia& ICU in the Department of Cardiac Sciences, and Dr Ashok Kumar, Consultant Interventional Cardiology in the Department of Cardiac Sciences were present at the event.

Cardiac Support group - Privelge Card Benefits :

1. First consultation free for all specialties including Physiotherapy services

2. 25% discount on all consultations subsequently.

3. 25% discount on wound care consultations for first 6 months following cardiac procedure

4. Free anticoagulation/antiplatelet advice (by consultant or anticoagulation nurse) for first 6 moths following cardiac procedure

5. 20% discount on Radiology and Lab

6. 10% discount of OP pharmacy

7. 30% discount of MHC packages

8. In-patients- 10% discount of room rent, lab and radiology.