For the first time, doctors used 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. He was given fever-reducing medicine and a cooling bath, but it did not go down. A day later, baby Y. still had a high fever, was drowsy, had shaking hands and feet, was startled many times when awake, had difficulty breathing, and had purple rashes all over his body. The family took baby Y. to a higher level hospital, where he 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 intervention. However, due to severe heart damage (myocardial cell necrosis, cardiac enzymes increased >5,000 times compared to normal); complex arrhythmia, falling into ventricular tachycardia, affecting hemodynamics. Doctors treated him with electric shock multiple times, administered antiarrhythmic drugs and performed 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; heart damage began to recover, other organs and nerves stabilized, the baby was weaned off ECMO. The stool test results were 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 the department is where severe hand, foot and mouth disease is admitted and treated. 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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