"Urgent! Hurry to Wenzhou to transport premature babies weighing only 1.8 kg. On September 7, 2021, Li Chunxiang, a cardiothoracic surgeon at Shanghai Children's Medical Center, suddenly received a task.
It turned out that the child was manifested as respiratory distress after birth, and could only be treated mechanically through endotracheal intubation, but subglottic stenosis was found during intubation, intubation could not enter the airway normally, local hospital treatment was ineffective, the child still had difficulty ventilating, continued hypercapnia, could not get out of the ventilator, and due to subglottic stenosis, the endotracheal intubation was extremely shallow, and the endotracheal intubation slipped out many times in the ICU. Therefore, to successfully transport this child, it is very challenging to ensure the lifeline on the bumpy road, and the location of the endotracheal intubation.
After more than 5 hours of driving, Li Xiangxiang and colleagues have been cautious, and finally the child arrived safely at the cardiothoracic surgery intensive care unit of Shanghai Children's Medical Center, "On the road, I can't even take care of motion sickness, I am afraid of intubation slipping out, this consequence can not think!" Dr. Zhu Limin, who received the child, gave a thumbs up: "Thanks to the experienced transport team, the child's vital signs were relatively stable when he arrived at the hospital." "But because the intubation can't be placed in a normal position, the child is still on the line."
The cardiothoracic surgery tracheal treatment team worked overnight to improve preoperative examination, discuss the condition, and formulate a surgical plan. On September 8, the operation was performed by Wang Shunmin's team, and the child was only the size of an adult's palm and the lowest-weight tracheal stenosis the team had ever met. For this "mini" baby, we have prepared the most sophisticated surgical instruments and the thinnest tracheoscope, and strive to achieve the best results of tracheoplasty. After more than 2 hours of intense work, with the completion of the last stitch of the trachea, when the ventilator is connected, the baby's lungs are smoothly bulging, and the baby's airway is unobstructed!
After undergoing difficult surgery, the baby must also face the "big mark" of postoperative monitoring. Because the baby is a 26-week premature baby, a series of problems in the premature baby are difficulties that affect the recovery. The respiratory treatment team of the intensive care unit has used the international advanced "neuromodulatory assisted ventilation" technology to specially formulate a series of treatment strategies such as cardiopulmonary function maintenance, postoperative infection prevention and treatment, nutritional status adjustment and so on... After 1 week of mechanical ventilation, the baby successfully removed the endotracheal intubation, transitioned to a state of noninvasive ventilation, and finally successfully escaped from the ventilator 11 days after the operation. At this point, the "slap" baby who has been relying on tracheal intubation to maintain breathing for more than 2 months after birth can finally breathe freely and freely.
It is reported that the tracheal treatment team of Shanghai Children's Medical Center was pioneered by Professor Xu Zhiwei and is the earliest team in China to carry out such surgery. In the past ten years, more than 500 cases of tracheal malformation correction surgery have been completed, reaching the international advanced level, and the success rate is more than 90%.
Responsible Editor Liqi Ni
Source Pudong Release