Baby's life saved after pioneering intensive care treatment
Posted on Friday 15th November 2019
Baby Reva with mum Parnika and the intensive care team
The smallest baby in the UK to receive a pioneering life support treatment has celebrated her first birthday thanks to Evelina London.
Reva Malvankar, became critically ill with a respiratory infection at nine weeks old after she was born prematurely at 30 weeks. She spent six days in intensive care at St George’s Hospital in South London but her condition continued to deteriorate.
In a last effort to save her life doctors at St George’s contacted the specialist Extracorporeal Membrane Oxygenation (ECMO) team at Evelina London and the intensive care transport team, the South Thames Retrieval Service, collected Reva and brought her to Evelina London for treatment.
ECMO treatment temporarily replaces the work of the lungs or heart in patients with severe lung or heart failure, allowing their organs to heal. It continuously takes blood from the body, adds oxygen, removes carbon dioxide and then returns it to the body.
Due to her very small weight, Reva received a special type of ECMO for the lungs, where blood is taken from one part of the body and returned to another.
The standard procedure, where blood is taken from and returned to the same site, is designed for bigger babies and adults and has a higher risk of serious complications in smaller babies.
The procedure had never been attempted on a baby as small as Reva before in the UK. At the time of the treatment, Reva weighed just 4Ib 10oz (2.1kg) making her the smallest baby in the UK to receive ECMO for the lungs.
Reva’s mother, Parnika Bhor, 42, from Epsom in Surrey said: “Reva didn’t have any serious medical problems and after spending six weeks in the neonatal ward at our local hospital we were discharged home.
“After three weeks at home she developed a respiratory infection. At first she didn’t seem to be in any major discomfort but her temperature was very low. She then started to become very floppy so we took her to our local A&E. Her condition continued to deteriorate so after a couple of hours she was transferred to St George’s Hospital. She spent six days there but there was no change to her condition.
“We were told that the respiratory infection was stopping her lungs from working properly and her life was in serious danger. We couldn’t bear the thought of losing Reva. We were completely broken.
“The team at Evelina London explained that Reva would need a special type of ECMO because of her small weight and that it was her only option left. It was extremely distressing seeing her tiny body hooked up to such a big machine.
“After ten days on ECMO her condition started to improve. Gradually the team reduced the amount of support her lungs were getting from the machine. Reva wouldn’t be alive today without it. I’m eternally grateful to Evelina London for the care she received.”
Reva stayed on ECMO for two weeks and was discharged from the paediatric intensive care unit a few weeks later and spent a month recovering in her local hospital. Reva continues to receive follow up care at Evelina London to monitor her health.
Parnika said: “Reva is now a healthy, happy, one-year-old. She has started crawling and loves books and playing with her toys. We had a lovely celebration with our friends and family for her first birthday. It was such a joy to see her playing with friends and enjoying herself like any normal, healthy child. When she was seriously ill we didn’t think we would ever get to this point.”
Dr Jon Lillie, consultant in paediatric intensive care at Evelina London, said: “We are so glad that Reva is thriving and doing well. In the procedure that she had blood was taken from her neck and returned to her groin, which we believe is safer than the standard procedure for a baby of her size. We are unique in the UK in being able to offer this type of treatment to very small babies. Until now it hadn’t been attempted before as it was assumed that is wasn’t possible.
“At Evelina London we are very fortunate to have teams who are able to provide pioneering treatment like this. Placing a baby on ECMO is very challenging and requires lots of support from for our doctors, surgeons, nurses, therapists and perfusion team. Without it Reva wouldn’t have survived.”
Our Evelina 150 Stories
Reva's journey is part of a series of Evelina 150 Stories that we are sharing in celebration of our special 150th anniversary year.
150 years ago, Evelina London was born out of love, when Baron Ferdinand de Rothschild founded the hospital in memory of his wife, Evelina. Since 1869, we've been saving lives, improving health and inspiring better futures.
Find out more about how we are marking our special birthday: evelinalondon.nhs.uk/150