Timely use of ECMO technique to save the life of a child with critical myocarditis

On April 26, Dr. Vo Van Nguyen Loi and other doctors from the Pediatric Center, Hue Central Hospital, visited the home of patient NTV (7 years old, residing in Huong Thuy Town, Hue City) to examine him after nearly half a month of ECMO (extracorporeal membrane oxygenation) to save his life at the hospital.

V. (red shirt, sitting) has returned to normal life with her mother and siblings.

PHOTO: VVNL

Currently, V.'s health has gradually recovered and is progressing well. "His heart functions have basically recovered. In the coming time, with the cooperation of many specialists using ECMO technology, we hope to be able to save more children with dangerous acute diseases like this," affirmed Dr. Vo Van Nguyen Loi.

Ms. Pham Thi Trang, NTV's mother, could not hide her happiness: "When she had a severe cardiogenic shock seizure, the family was extremely worried because this situation had never happened before. But immediately after being transferred to Hue Central Hospital, through monitoring and assessing the situation, the team of the Pediatric Intensive Care - Emergency Department promptly activated the ECMO procedure, thanks to which she was saved."

On March 18, NVT appeared to be very tired and had convulsions and was taken to Hue University of Medicine and Pharmacy Hospital. There, doctors discovered a slow heart rate with a third-degree atrioventricular block - a serious heart conduction disorder - so they immediately transferred the patient to Hue Central Hospital.

Doctor Vo Van Nguyen Loi directly examined V. at home.

PHOTO: VVNL

Admitted to the Pediatric Intensive Care - Emergency Department, Hue Central Hospital, patient V. was still conscious but vital signs showed a critical condition: cold hands and feet, sweating, heart rate only 30 - 40 beats/minute, diagnosed with fulminant myocarditis complicated by third-degree atrioventricular block causing severe cardiogenic shock, high risk of death.

Doctors immediately established an airway, used a combination of two cardiac medications to raise blood pressure and heart rate to a minimum safe level, and activated the red alert protocol. An urgent consultation with the Cardiovascular Intervention Department was conducted to place a temporary pacemaker, and activated the hospital's ECMO team to be ready to assist if needed.

After the pacemaker was placed, the child's hemodynamics improved, giving the treatment team initial hope. However, in the next 2 days of monitoring, heart function continued to decline, remaining only 1/3 of normal, threatening the child's life.

Timely life-and-death moment saves child's life

Faced with the heart's "gradual exhaustion", on April 16, the Pediatric Intensive Care - Emergency Department decided to use ECMO to support circulation and respiration, helping the child's heart "rest" and have a chance to recover.

The ECMO procedure is implemented synchronously with close coordination between the departments of Thoracic Surgery - Cardiology and Anesthesia - Cardiology.

After 5 days of ECMO, the patient's heart function improved significantly. After that, the child was removed from ECMO, the pacemaker was stopped, and the ventilator was successfully removed.

The treatment team was happy after successfully removing ECMO, stopping the pacemaker and weaning V off the ventilator.

PHOTO: VVNL

The treatment process lasted more than 1 month, with close monitoring and intensive care from the medical team. The treatment results were spectacularly successful, the baby recovered completely, could walk normally, cardiovascular and hemodynamic indicators returned to stability and was discharged on April 23.

Professor - Doctor Pham Nhu Hiep, Director of Hue Central Hospital, said: "ECMO technique was successfully performed for the first time in Vietnam by Hue Central Hospital in March 2009, mainly for patients with cardiogenic shock, myocarditis, cardiovascular surgery, and progressive acute respiratory failure with ineffective mechanical ventilation. Currently, this technique has been routinely performed at the hospital's pediatric center."

According to Professor - Doctor Pham Nhu Hiep, with the synchronous coordination of related specialties along with modern machinery, equipment, high-quality medical staff..., the hospital has successfully treated serious and critical pediatric patients at the hospital and transferred from lower-level hospitals.

Source: https://thanhnien.vn/kip-thoi-dung-ky-thuat-ecmo-cuu-song-benh-nhi-viem-co-tim-nguy-kich-185250426181111245.htm