Rape victim ‘extremely critical’, has severe cardiac problems

The 23-year-old Delhi gangrape victim who was moved to Singapore's Mount Elizabeth Hospital last night suffered a cardiac arrest in the early hours of Wednesday which has led to severe cardiac complications. While the Mount Elizabeth authorities described her condition as "extremely critical" in a statement issued on Thursday evening, highly placed sources said there were at least two "positive signs" by Thursday night.

According to these sources, the victim's heart rate was down from 165 beats per minute to about 100 beats per minute. She was also able to pass urine by the end of the day.

Earlier, during the six-hour flight from Delhi to Singapore, the team of doctors from Safdarjung Hospital and Medanta who were accompanying her had to perform an arterial cannulation procedure to closely monitor her blood pressure after it showed a steep fall.

As soon as she arrived at the Singapore hospital at around 7 am, a whole body CT scan was performed, after which she was immediately transferred to the ICU. She has been placed under the care of Dr Denis Nyam, a general surgeon who is leading a multi-disciplinary team of five doctors which coordinated her transfer to Singapore.

"As at 7 pm (Singapore time) the patient remains in an extremely critical condition. She is under treatment at Mount Elizabeth Hospital's intensive care unit. Prior to her arrival, she has already undergone three abdominal surgeries, and experienced a cardiac arrest in India. A multi-disciplinary team of specialists is taking care of her and doing everything possible to stabilise her condition," said Dr Kevin Loh, CEO of the Mount Elizabeth hospital.

According to sources, on Thursday afternoon, the victim's ejection fraction — the volume of blood being pumped out of the heart at every heart beat — that was already low, had "further significantly lowered". "There is also some problem in the movement of her heart muscles — a condition known as akinesia," said a source.

The cardiac complications surfaced at around 1 am on Wednesday, when a thromboembolic attack — a clot in key vessels near her heart — triggered a cardiac arrest. "From 1 am to 3 am, all sources had to be mobilised to stabilise her condition. No heart rate could be found for three-four minutes, and her pulse rate had become critically low. Cardio-pulmonary resuscitation was performed for about four minutes, before she could be revived," said a source. Sources added that loss of possible brain function during the period of cardiac arrest was yet to be ascertained.

Meanwhile, sources confirmed that the Mount Elizabeth hospital, which, according to an official statement, was chosen because of its successful multi-organ transplant facilities, has not performed any complete intestinal transplant procedure yet. These sources said intestinal transplants had been performed in only three places in the world — Leeds and Cambridge in the UK and Toronto in Canada.

"Considering her condition, our primary aim is to control the spread of infection, and now the latest cardiac complications. She needs proper ICU care in the immediate future, the possibility of a transplant cannot even be considered for at least six months," said a source.

In Delhi, Home Minister Sushil Kumar Shinde said: "We are all aware of the critical condition of the victim. Since the day of the incident, it has been our endeavour to provide her the best medical care. Despite the best efforts of our doctors, the victim continues to be critical and her fluctuating health remains a big cause of concern to all of us."

While the team of doctors from India who accompanied the victim are expected to return on Friday, sources said Dr P K Verma, intensive critical care unit in-charge at Safdarjung Hospital, is likely to remain in Singapore.

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