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HindustanTimes Tue,21 May 2013

Machine helping Thackeray breathe

Menaka Rao, Hindustan Times  Mumbai, November 16, 2012
First Published: 02:54 IST(16/11/2012) | Last Updated: 02:56 IST(16/11/2012)
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Shiv Sena chief Bal Thackeray, whose condition turned critical on Wednesday night, has been put on a machine for the past few days after he found it difficult to breathe on his own.

The machine — Bi-Level Positive Airway Pressure (BiPAP) — is used when a patient cannot breathe effectively enough to maximise the transport of oxygen into the lungs and then into the blood. It can at times be used instead of a ventilator.

“BiPAP is a non-invasive ventilator with a mask fitted to a ventilator. A conventional ventilator, on the other hand, is fitted with an endo-tracheal tube in the neck region connected to the ventilator. For an intensivist to use BiPAP, the patient has to be conscious or making some of his own effort in breathing. This is normally used in chronic obstructive pulmonary disease,” said a consulting physician on condition of anonymity.

Thackeray has multi-organ failure, including renal failure, said sources. However, some Shiv Sena functionaries who visited Thackeray late evening said his pulse rate ranged between 60 and 70.

“In such critical cases, we call this a terminal rhythm where the heart shows some activity but does not contribute enough to keep vital organs alive. In cases of multi-organ failure, the prognosis is not good,” said the doctor.

Since the past few days, a team of four to five doctors, including his primary physician, Dr Jalil Parkar and intensivists from Lilavati hospital, Bandra, were visiting Thackeray at least three times a day.

The team of doctors that tended to him on Wednesday night returned on Thursday morning. Sources said that he wished not to be hospitalised.

Earlier he was hospitalised with a severe stomach pain and was suggested endoscopy by Hyderabad-based interventional gastroenterologist Dr Nageshwar Reddy. The family, however, deferred the decision after preliminary meeting with the doctor.

In 2009, Thackeray underwent angioplasty for three blockages in his heart vessels. He had undergone bypass surgery in 1996 and suffered from chronic obstructive pulmonary disease that was controlled by medication.

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