Dr Mothilal is able to assist in emergency respiratory care in cases where breathing is compromised. Through non-invasive, invasive and advanced ventilation strategies, extracorporeal membrane oxygenation (ECMO) and chest drainage and indwelling pleural catheters he is a specialist pulmonologist with experience in emergency ventilation in acute respiratory failure.
Non-invasive ventilation (NIV) refers to the provision of ventilatory support through the patient's upper airway using a mask. Non-invasive ventilation (NIV) may be used in cases of acute exacerbations (such as Asthma or COPD), or for mild to moderate or hypervolemic pulmonary oedemas. Invasive and advanced ventilation strategies on the other hand are done using a tracheal tube, laryngeal mask, or tracheostomy, bypassing the upper respiratory tract. More invasive ventilation is chosen in clinical cases in which airways, breathing, circulation and disability are at risk. It may be done for airway protection, apnoea hyperventilation, respiratory distress, severe circulatory shock, controlled hyperventilation or in cases of poor blood gases or failed pulmonary function tests.
There is a range of conditions affecting the lung mechanics and gas exchange, lung compliance, airflow and restriction of the chest wall, for which emergency ventilation may be needed. Those in need of intubation, non-invasive, invasive and advanced ventilation include:
In cases where ventilation may not be sufficient or sustainable due to the high-pressure rate of oxygen supplied by these machines, ECMO services may be better suited.
Extracorporeal membrane oxygenation (ECMO) is provided to those for temporary support in cases of heart and/or lung failure. ECMO works by supplementing the responsibilities of the lungs and heart by adding oxygen to the blood and helping the heart pump properly so that the heart and/or lungs can recuperate. While ventilation may assist in such cases, extracorporeal membrane oxygenation is able to spare the effort of the lung completely, oxygenating the blood outside the body to serve oxygenated blood to the organs. ECMO is often used for infants, young children and adults (in severe cases) for pneumonia, sepsis, lung failure, heart failure, post-cardiac syndrome, temporary bridging and bridging therapy. In cases where fluid has built up in the pleural space, chest drainage through indwelling pleural catheters may be considered
Chest drainage, also known as pleural effusion drainage, is done to remove the fluid from the space between your lungs and chest cavity, the pleural space. For chest drainage, an indwelling pleural catheter is placed during a procedure known as a thoracostomy. During a thoracostomy. The chest tube (or thoracoscope), a thin plastic tube, inserted into the pleural space connected to a machine to help drain air, blood, or fluid that may be placing pressure on the lung. This chest tube remains, and once the fluid or air is removed, your lungs should be able to expand properly. Pleural effusion drainage or chest drainage is usually indicated to maintain respiratory function which may be compromised by the build-up of air, blood or fluid in the pleural space. This is often caused by: