Recently, the neonatology team of the Obstetrics and Gynecology Hospital of Fudan University successfully rescued a newborn with spontaneous bilateral tension pneumothorax. Neonatal pneumothorax is a pathological situation, the child with respiratory movement, inhaled gas through the rupture into the pleural cavity, such as the emergence of tension pneumothorax, the child's pleural cavity gas continues to intensify, easy to compress the lungs and heart, such as the rapid progression of the course of the disease, will lead to neonatal shock or even death, is a fatal critical disease. Under the joint relay of the neonatology team of the Obstetrics and Gynecology Hospital affiliated to Fudan University, the Xinhua Hospital affiliated to the School of Medicine of Jiaotong University, and the 120 Emergency Center, the child has been successfully extubated and evacuated, and his vital signs are stable and his recovery is good.
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20 hours after birth, face the test of life and death
Xiao Bao is a full-term baby boy, born due to "shortness of breath" into the neonatal intensive care unit of fudan university affiliated obstetrics and gynecology hospital, 20 hours after birth, Xiao Bao, who was originally in stable condition under oxygen inhalation, suddenly appeared cyanosis, irritability, and blood oxygen saturation fell all the way.
"Your child may have pneumothorax!" You Xueqin, a doctor on duty, and Zhang Zizhen, a nurse, quickly launched rescue, intubated the trachea, pressurized oxygen, and connected to a ventilator, which built a "life channel" for Xiaobao. Dr. Chen Yun immediately confirmed the diagnosis of "pneumothorax" with bedside ultrasound. It is understood that children with pneumothorax often have sudden increased breathing difficulties, and their condition is dangerous and can be life-threatening when severe.
However, the child develops cyanosis again under mechanical endotracheal intubation and oxygen saturation continues to decline.
"I am in a critical condition and need urgent chest closure drainage!" Contact bedside camera! With a solid professional foundation and rich clinical experience, Dr. Wang Huijuan quickly completed the left chest puncture and indwelled water sealing bottle through precise positioning through bedside ultrasound. As the gas in the left chest cavity was continuously pumped out, Xiao Bao's blood oxygen saturation rose to more than 90%, and his face returned to rosy.
Looking at Xiaobao, who was quietly sleeping, the neonatal medical team did not let down their vigilance, and they closely monitored the child's vital signs. During the monitoring process, the child suddenly re-developed symptoms of decreased blood oxygen, cyanosis, and restlessness.
"Adjust ventilator parameters to maintain blood oxygen stability!" In the race against life, every second of treatment time is extremely important to the child.
Soon, the chest x-ray report came! Originally, after the chest puncture, Xiao Bao's left pneumothorax was significantly improved, but the right lung was compressed by about 50%! "The child is spontaneously bilateral pneumothorax!" Dr. Zhuang Xiaolei immediately made a chest puncture on Xiao Bao's right side, and soon the blood oxygen began to rise, and the breathing gradually improved.
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Three-way relay rescue to open up a life channel
It is well known that neonatal treatment is more difficult than that of adults. Timely intervention is essential to save the child's life. Especially for a rare case of bilateral spontaneous pneumothorax in newborns like Xiaobao, any one link that goes wrong can be life-threatening.
When the child's condition suddenly changed suddenly, the Red House neonatal team screened and performed chest puncture drainage for the first time, which won a valuable "first stick" for timely treatment. So, how do you get your kids to win the final victory?
The neonatology team made further plans for Xiaobao. "The child's unexplained spontaneous bilateral pneumothorax needs to relieve the child's pain, reduce crying, and prevent further exacerbation of the pneumothorax. At the same time, invite pediatric surgeons to assist in diagnosis and treatment, and when the vital signs are stable, they will be referred to a pediatric specialist hospital! ”
Urgently dispense drugs, check infusions, improve examinations, write treatment records, communicate with patients' families, contact consultation and referral... They started racing for time and speed!
Since the outbreak of the epidemic, Shanghai has given priority to ensuring the transport and treatment needs of critically ill patients, pregnant women and newborns, and made every effort to maintain the smooth passage of referral channels for pregnant women and critically ill newborns. After learning of the condition, Xinhua Hospital affiliated to jiaotong University School of Medicine immediately arranged for a professional team to arrive at the scene, and the 120 center urgently deployed an emergency transport vehicle, and soon Xiaobao was safely transferred to the intensive care unit of Xinhua Hospital.
Recently, the good news came: Xiaobao has successfully extubated and withdrawn, his vital signs are stable, and his recovery is good!
"In neonatology, rescuing critically ill children is like a thrilling relay race." Wang Jimei, director of the Department of Neonatology, said frankly: "In the special epidemic period, in the face of critically ill newborns, although all our medical staff are not in the same hospital and not in the same battlefield, our goal is the same, that is, to work together to win precious time for children! ”
It is reported that since the outbreak of the epidemic, most medical workers have been stationed in the hospital for many consecutive days to build a solid safety barrier for the lives of newborns. Since the end of March, nearly 700 newborns have arrived safely.
Although the epidemic has not dissipated, the new life is hope!
Author: Li Min Wang Huijuan
Review: Wang Jimei
Editor: Li Miaoran