For the first time, doctors use ECMO to save a child with severe hand, foot and mouth disease.

On the morning of August 5, Dr. Vo Thanh Luan, Deputy Head of the COVID-19 Infection Resuscitation Department, Children's Hospital 2 (HCMC) said that doctors here had just performed the ECMO method (artificial heart and lung) to save a child patient TNY (5 years old, living in HCMC) with grade 4 hand, foot and mouth disease. This is the first child patient in the country to perform this method to treat hand, foot and mouth disease.

Lần đầu tiên, bác sĩ sử dụng ECMO cứu trẻ mắc tay chân miệng nặng - Ảnh 1.

Doctors consulted to give treatment method for baby Y. (Photo: Provided by the hospital)

According to the medical history, baby Y. had a headache and high fever. She was given fever-reducing medicine and cooled down with a towel but it did not go down. A day later, baby Y. still had a high fever, was lethargic, had shaking hands and feet, was startled many times when awake, had difficulty breathing, and had purple rashes all over her body. The family took baby Y. to a higher level hospital, where she was diagnosed with grade 4 hand, foot and mouth disease, treated with endotracheal intubation, respiratory support, and quickly transferred to Children's Hospital 2.

Lần đầu tiên, bác sĩ sử dụng ECMO cứu trẻ mắc tay chân miệng nặng - Ảnh 2.

After 3 weeks of intensive treatment, baby Y. has overcome the critical stage and will soon be discharged from the hospital. (Photo: Provided by the hospital)

At the hospital, baby Y. was put on a ventilator, given IVIg (Immunoglobulin), used vasopressors, cardiac support drugs and continuous blood filtration. However, due to severe heart damage (myocardial cell necrosis, cardiac enzymes increased >5,000 times compared to normal); complex arrhythmia, ventricular tachycardia, affecting hemodynamics. Doctors treated him with multiple electric shocks, antiarrhythmic drugs and cardiopulmonary resuscitation but there was still no improvement.

Therefore, a hospital-wide consultation was held. After examining and assessing the patient's condition, the doctors found that although baby Y. had severe heart and lung damage, he was still neurologically responsive, so they decided to intervene with ECMO technology for the baby.

"At the time of preparing for ECMO intervention, the patient's heart gradually weakened, the heart rate decreased and became erratic, and blood pressure dropped continuously. Doctors had to take turns performing cardiopulmonary resuscitation, external cardiac massage, and urgently install and operate the extracorporeal circulation system," said Dr. Luan.

After 5 days of ECMO with mechanical ventilation, blood filtration, vasopressors, cardiac support, nutrition, infection control... the baby's clinical signs improved; the heart damage began to recover, other organs and nerves were stable, the baby was weaned off ECMO. The stool test result was positive for EV71, the agent that causes severe hand, foot and mouth disease.

Dr. Do Chau Viet, Head of the Department of Infectious Diseases and COVID-19 Resuscitation, said that the department is a place to receive and treat severe hand, foot and mouth disease. Most children respond well to the current treatment regimen. However, baby Y. is the first special case in the hospital and in the whole country to be treated with ECMO as a life-saving measure.

After 3 weeks of treatment, the baby's health is now stable, his nerves have improved, he is eating normally and will be discharged from the hospital as soon as possible.

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