Vadodara: A 23-year-old woman who suffered cardiac arrest after ingesting a lethal dose of aluminium phosphide was revived using ECMO-assisted CPR (E-CPR), with doctors reporting a full neurological recovery.The woman was brought to the ICU in cardiogenic shock about three hours after ingesting aluminium phosphide, commercially sold as the fumigant Quickphos.Her condition was critical, with dangerously high lactate levels, multiple life-threatening heart-rhythm disturbances and her heart functioning at only 15-20% of its normal pumping capacity.Aluminium phosphide poisoning has a very high mortality rate because it can cause rapid and severe heart-muscle failure.Before the ECMO circuit could be fully established, the patient’s heart stopped. Doctors at Aadicura Superspeciality Hospital began E-CPR during the cardiac arrest itself, while continuing chest compressions, intubation and repeated defibrillation.Unlike conventional ECMO, which is generally started after a patient’s heartbeat has returned, E-CPR uses a portable extracorporeal membrane oxygenation (ECMO) machine to take over the functions of the heart and lungs while cardiac arrest is still ongoing.The ECMO team led by Dr Vishal Sardhara, along with vascular surgeons Dr Kushan Nanavati and Dr Parth Joshi, established circulatory support while the patient’s heart was still in ventricular fibrillation. The treatment restored blood and oxygen supply to her brain and other organs while doctors continued efforts to stabilise her heart.“With this kind of poisoning, the heart muscle fails very quickly, and once that happens, conventional resuscitation rarely works,” said Dr Ravirajsinh Gohil, who led the ICU team.The patient regained consciousness within hours and began responding to commands even though her heart rhythm remained unstable. Her heart function gradually improved, reaching 25-30% over the next 48 hours. She was weaned off ECMO on July 12, 2026, after 48 hours, and remained on ventilator support for another four to five days.She was discharged recently with a Glasgow Coma Scale score of 15/15, indicating full neurological recovery without lasting brain injury.
