61-year-old Ms. Zhang was discharged from the hospital for half a month, and she still has palpitations, and she was admitted to the ICU after eating a cold egg!
Is it a "pot" for cold eggs?
On March 28, Ms. Zhang felt some bloating after eating a cold egg during the day, and then had more than 10 episodes of diarrhea (yellow watery stools) that night, accompanied by nausea, vomiting, shortness of breath, chest tightness, general weakness and other symptoms, and the treatment effect in the local hospital was not good and the symptoms continued to worsen, and she was urgently transferred to the ICU (intensive care department) of Xianyang Central Hospital at 2 a.m. on the 29th.
ICU medical staff urgently examined and actively responded, only to see that the patient's mental state was poor, shortness of breath, cyanosis of the lips, cold hands and feet, after giving high-flow oxygen and symptomatic treatment, the condition still did not improve, and the monitoring of blood gas showed that the oxygenation index was 67mmHg, and accompanied by severe acidemia.
At 9 a.m., even under the condition of ventilator assistance and 100% pure oxygen support, Ms. Zhang's blood oxygen saturation was still difficult to maintain, the acidosis progressively worsened, the oxygenation index dropped to 59mmHg, the patient began to have consciousness disorders, restlessness, blood oxygen saturation continued to be below 80%, and was diagnosed with severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock, acute gastrointestinal infection, etc.
In fact, combined with the past medical history, the medical staff analyzed that it was not the "pot" of eggs, and the patient had previously had mycoplasma lung infection and gastrointestinal infection, but did not care about it because there was no obvious discomfort.
In any case, the big question at the moment is, how to save Ms. Zhang, who is in danger?
ECMO treatment has taken a big turnaround
After the ICU collective discussion, it was believed that the patient Ms. Zhang was in line with the current ultimate treatment method for critically ill patients - ECMO (extracorporeal membrane oxygenation support) start-up indication, and after obtaining the consent of the family, the EMCO treatment team immediately took action, quickly punctured the catheter, prefilled the tube, completed the ECMO on the machine, and monitored the finger pulse oxygen saturation on the monitor from 65% to 75%,...... 100% continues to rise, the patient's breathing gradually smooths out, the skin color gradually improves, the whole group is excited, and the hanging heart can finally be put down.
Bedside ECMO therapy
ECMO combined with ventilator and CRRT assisted support
An MDT (multidisciplinary consultation) was soon launched, and the clinical pharmacy department, gastroenterology, gastrointestinal surgery, ultrasound diagnosis department, imaging center, laboratory department, hemodialysis center and other departments jointly participated in the treatment, and formulated an individualized diagnosis and treatment plan for the patient.
For example, in order to improve the patient's hypoxia symptoms, the nursing team performs prone ventilation for 12-16 hours a day, and closely observes every little detail under the combined support of ECMO + CRRT (continuous blood purification therapy) + ventilator.
Comparison of chest X-ray after ECMO in patients
Comparison of chest CT after ECMO in patients
After continuous treatment, Ms. Zhang's breathing gradually stabilized, her hemodynamics were stable, her double pneumonia dissipated, her organ function returned to normal, and her ECMO and ventilator were gradually stopped, and she regained her life.
To express their gratitude, Ms. Zhang and her family made a pennant and sent it to the ICU, where she was discharged from the hospital on April 10.
Handwritten thank-you note from the patient
Fantastic ECMO
ECMO is mainly aimed at cardiorespiratory arrest, severe cardiopulmonary failure and other diseases caused by various reasons, it can lead the patient's blood from the body to the outside of the body, and then use the blood pump or extracorporeal bypass machine to transfuse the blood back into the human body after membrane oxygenation, so as to temporarily replace part of the patient's cardiopulmonary function and win time for follow-up treatment.
In January 2023, the ICU of Xianyang Central Hospital began to independently carry out ECMO technology, and the team has mature technology, and has carried out more than 20 cases of ECMO so far, successfully treating many critically ill patients. (Li Kang)