Health

51 days of fighting Covid of a teenager weighing 120 kg


Minh Phong, 15 years old, discharged from the hospital on December 24, was amused by the doctor as a “small pilot” because his journey to victory over Covid-19 was as spectacular as the British pilot (“patient 91”).

Phong entered the City Children’s Hospital on the evening of November 4 after three days of high fever, phlegm cough, shortness of breath, chest pain gradually increasing, blood oxygen concentration (SpO2) about 90%. The boy tested positive for Covid-19, had not been vaccinated, was obese, and was predicted to get worse.

Doctor Nguyen Minh Tien (Deputy Director of the Hospital) said that the patient’s respiratory failure rapidly increased, even though he was intubated to help him breathe, the ventilator with a high parameter still did not improve, so the doctors had to take into account. ECMO intervention plan during the night. This is a device that oxidizes through the outer membrane of the body – a weapon, the last means of respiratory support for critical cases caused by Covid-19.

The team consisted of 6 doctors, 8 nurses in protective clothing, and coordinated to attach the EMCO system to the baby’s body until 1:30 am to complete. “Even though it’s late at night, we still have to do it urgently because the baby’s condition is critical, in terms of golden hours and golden minutes, we can’t wait until morning,” said Doctor Tien. This vehicle helps the baby’s blood oxygen index and ventilator parameters improve markedly.

Doctors and nurses coordinated to connect EMCO to Phong’s body during the night. Photo: Hospital provides

According to Dr. Tien, the baby received maximum aseptic care in a negative pressure room, but still had episodes of sepsis and fungal infections, requiring broad-spectrum antibiotic treatment. The inflammatory response of the pediatric patient was continuously increased very high (cytokine storm), and had to undergo dialysis to absorb cytokines 4 times. After stopping dialysis, the doctor decided to move from the Infection Department to the Anti-Poison Intensive Care Department for convenient treatment, on November 26.

“In order to move the baby with the ECMO system and bulky machines, Dr. Le Vu Phuong Thy had to make a 3-page plan, meticulously detailing the machinery and personnel, to avoid any mishaps.” Dr. Tien said. At the ICU, the baby improved gradually, no fever, ventilator parameters gradually decreased, breathing was good, chest X-ray improved, vital signs were stable. Phong was stopped from running ECMO after 26 days, weaned off the ventilator after, practiced breathing, and exercised.

Nurse Nguyen Thi Thang, Department of Intensive Care Against Poisons, said that the baby’s condition was severe and her body was overweight, so the nurses had to coordinate with 3-4 people to be able to turn, take care of, and maintain personal hygiene. for the baby, instead of just one person as usual. Hospitals must set up teams specializing in wound care, groups specializing in ECMO, physical therapy, and psychology to coordinate to bring the best results.

The practice of physical therapy for children also encounters many difficulties. Specialist Do Bich Thuan said that every time she practiced for her baby, she was drenched in sweat. When she returned to the department for more than half an hour, she was still very tired because the baby had a lot of mucus, she had to practice ventilation, lift her limbs to exercise very hard. “I’m both stressed and nervous because the baby’s progress has been very bad at times, and determined to contribute to the end to support her to overcome,” said specialist Thuan.

Doctor Nguyen Dat Thinh bought clothes and shoes from his own pocket, after learning that he no longer had a father.  We try to let her feel that this is not a cold hospital full of antiseptics, but a place full of love and warmth, said Dr. Thinh.  Photo: Provided by the hospital

Doctor Nguyen Dat Thinh bought clothes and shoes from his own pocket, after learning that he no longer had a father. “We try to let the baby feel that this is not a cold hospital full of antiseptics, but a place full of love and warmth,” said Dr. Thinh. Photo: Hospital provides

Doctor, Doctor Truong Quang Dinh (Director of City Children’s Hospital), said the image of the baby recovering from the hospital is a great gift for the doctors and nurses on Christmas. “This is a spectacular revival, during the treatment there were many times when the waves seemed to let go, but it was at that time that we were more determined to overcome this challenge,” said Doctor Dinh.

Doctor Le Vu Phuong Thy, Head of the Intensive Care Unit Against Poisons, said that in 18 years of working in resuscitation, he has treated many serious patients, with a baby in the hospital for 3-4 months, but Phong is a special case. , leaving many emotions and impressions. The doctors and nurses were impressed with the resilient and brave boy who, when he started to regain consciousness, cooperated with the treatment team. “The period of breathing training was very challenging, she was very scared, always clutching the hands of the doctors and nurses, but in the end, she did it,” said Dr. Thy.

Phong’s will to live and his efforts to overcome serious illness is likened by doctors to a “small pilot”. “Patient 91” – the British pilot (who was once called a symbol of Vietnam’s comprehensive efforts in the pandemic by the world media) suffered severe lung damage, thought he needed a lung transplant but eventually overcame the challenge. item. Compared to weight, Phong is even better with 120 kg, 1m68 tall, BMI up to 46 (British pilot is 1.83m tall, weighs 100 kg, BMI is 30.1). This is a significant burden and challenge for care and treatment.

The cost after 51 days of treatment for the baby is more than 1.18 billion VND, of which the budget covers expenses related to Covid with more than 924 million, health insurance covers more than 10 million. Hospital fees of more than 251 million VND are mainly supported by benefactors.

After being discharged from the hospital, Phong continued to practice respiratory physiotherapy by himself, following the exercises instructed at home. The patient will be re-examined after a week to evaluate the ulcer in the back, assess respiratory function, and nutrition. The boy also re-examined the “post-Covid” package after a month at Superman Clinic, including general examination, testing, imaging, psychological assessment, nutrition…

Before being discharged from the hospital, baby Phong gave unicorn heads symbols - his work, thanking the doctors and nurses for saving his life, on the morning of December 24.  Photo: Le Phuong.

Before being discharged from the hospital, baby Phong gave unicorn heads symbols – his work, thanking the doctors and nurses for saving his life, on the morning of December 24. Photo: Le Phuong

From a weight of 120 kg, after nearly two months of arduous battle against Covid-19, Phong lost more than 90 kg. Orphaned early, leaving school to work as a hired worker since 5th grade, in addition to helping at the ironworks, Phong and his brother are members of a local team of lion lions and dragons. Before being discharged from the hospital, the boy gave a unicorn head symbol to thank the doctors and nurses for saving his life and wishes to return to the hospital to perform a lion dance for the children on important occasions.

Le Phuong