Lance Naik Hanamanthappa Koppad’s heart stopped at 1145AM on Thursday as he lost a daunting battle with hypothermia, a soldier’s most formidable adversary at the icy heights of Siachen.
Koppad was found buried under 35 feet of snow, six days after an avalanche buried him and nine fellow soldiers from 19 Madras Regiment in Siachen on February 3. He was rescued on Monday night and brought to Army Hospital Research and Referral (R and R) in New Delhi the next day.
“He was brought in a very critical state and wasn’t stable enough to be put on the extracorporeal membrane oxygenation (ECMO) machine used to treat hypothermia,” said a doctor who did not wish to be named due to not being authorised to speak to the media.
The ECMO works like a heart and lung machine that takes the blood out of the body, warms and oxygenates it, and pumps it back to support lung and heart function, which also brings the body’s core temperature back to normal.
A source said the patient’s condition was such that it was not possible to make him undergo the process. “ECMO would help when the lungs or heart need time for recovery. However, in his case, the kidneys had shut down and the brain was severely affected too.”
Instead, Koppad’s hypothermia was treated using warm intravenous fluids, humidified warm oxygen, and passive external rewarming, the source said.
The treatment couldn’t save Koppad, who slipped into a deeper state of coma and developed multiple-organ dysfunction. His kidneys failed completely.
According to Dr Yatin Mehta, the head of critical care at Medanta Hospital, the army hospital was among a few centres in India that have an ECMO machine.
“It works like a heart-lung machine and takes over the function of the two organs. The technique requires specialised equipment and people trained in handling the equipment. Medanta has used the machine to support a patient with a lung failure for about a month.”
Koppad was in an acute hypothermic state where the breathing, pulse rate and metabolism slow down to help conserve heat and energy.
For every one-degree drop in Celsius, the human body’s metabolism slows 5% to 7%, making it possible for the body to survive on limited oxygen.
He stopped responding to medicines, his pneumonia worsened, and the blood clotting disorder showed no sign of reversal. He was on maximal life support with aggressive ventilation and dialysis when he breathed his last.
“The country lost a brave soldier but each minute he lived after he was extricated alive will be remembered not only for the grit and will to survive on his part but also that he represented the spirit, patriotic commitment and will to fight it out under any adversary of each and every Indian soldier,” said Lt Gen BK Chopra, the director general of armed forces medical services, in his condolence note.