Baby boy escaped death after 6 days of breathing ECMO

Ho Chi Minh CityA 12-year-old boy with Covid-19 suffered from cardiogenic shock, myocarditis, and pericardial effusion, requiring ECMO intervention to regain his life.

Pediatric patient living in Vinh Loc A commune, Binh Chanh district started the disease with fever, no cough. On the second day, the baby had a fever with vomiting 2-3 times after eating, complaining of a lot of fatigue, so the family took him to the City Children’s Hospital. At this time, the baby’s skin is purple, blood pressure drops, heart rate is fast, Covid-19 test is positive. Echocardiography showed pericardial effusion, poor myocardial contractility, and elevated cardiac enzymes.

On April 6, Doctor Nguyen Minh Tien, deputy director of the City Children’s Hospital, said that despite being treated with intubation, mechanical ventilation, a combination of many measures such as sedation, vasopressor, antiviral, antiretroviral therapy. inflammation, antibiotics, pericardial drainage, but the patient’s condition progressed seriously, the shock did not improve, the myocardial contractility continued to decrease.

A 12-year-old boy with cardiogenic shock, pericardial effusion, myocarditis, acute Covid-19 was actively treated with ECMO mechanical ventilation, antiviral, anti-inflammatory, anticoagulant. Photo: City Children’s Hospital

Doctors decided to resort to performing extracorporeal membrane oxygenation (ECMO), correcting electrolyte and acid-base disorders. After 6 days of ECMO intervention, the patient’s condition gradually improved, reduced and stopped the vasopressors. She was weaned off ECMO, weaned off the ventilator, was awake, breathing air on her own, and is continuing to be treated at the Cardiology Department.

According to Dr. Tien, heart damage during the acute phase of Covid-19 can also occur but is not as prominent as the lung damage caused by nCoV that often attacks the lungs. In some cases, the virus enters the upper respiratory tract, attacks the blood and then the heart, mainly appearing in the first 2-3 days of Covid-19 infection.

“There are patients who have both lung damage and heart damage, especially this severe case of myocarditis is quite rare, the world’s documents only report individual cases, not many statistics,” said Dr. doctor said.

This is the first case of a child with myocarditis during Covid-19 who had to undergo ECMO intervention at the hospital. This patient was previously healthy, no obesity, no underlying disease. Currently, the cause as well as the risk target of the disease is unknown.

Doctors warn that myocarditis in children can occur during the acute phase of Covid-19, in addition to the post-Covid-19 period with multi-system inflammatory syndrome. Up to now, the hospital has recorded about 125 children with multisystem inflammation in the period of 2-6 weeks after recovering from Covid-19, the common manifestations are high fever for more than two days, skin rash, red eyes, abdominal pain, and diarrhea. diarrhea, vomiting …, mainly occur in children who have had Covid-19 with no symptoms or transient mild manifestations. The hospital is conducting ECMO on the 4th day to treat a 7-year-old girl living in Tay Ninh province suffering from multi-system inflammatory syndrome, acute myocarditis after two weeks of recovering from Covid-19.

“Although the rate of children becoming seriously ill when infected with Covid-19 is low, there are still cases of serious and life-threatening progression. Therefore, parents should pay attention to disease prevention and vaccinate their children to reduce the risk of contracting the disease as well. such as the possibility of aggravation, thereby reducing post-Covid risks”, Dr. Tien recommended.

Le Phuong


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