Recently, the family of the patient Xiuxiu (pseudonym) sent a pennant of "noble medical ethics and excellent medical skills, caring for patients and warming people's hearts" to the medical team of the Xiangzhu Intensive Care Medicine Department of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, expressing gratitude to the medical staff of the department.
▲The family presented a pennant to express their gratitude
Back in March 3 holiday, the Xiangzhu Intensive Care Medicine Department of our hospital received a call from a medical consortium hospital, and the other hospital admitted a 7-year-old girl Xiuxiu (pseudonym), who had repeated arrhythmias, and was in critical condition and needed to be transferred to our department for further treatment. After being admitted to the hospital, after expert consultation, it was considered that Xiuxiu had fulminant myocarditis, which had led to malignant arrhythmia and could cause cardiac arrest at any time.
▲Malignant arrhythmia
Although the family understands Xiuxiu's condition when they understand it, they are embarrassed when it comes to the use of ECMO treatment... After learning that the child's family economic situation was not optimistic and could not afford the cost of ECMO treatment, Zheng Jianqiu, Secretary of the Party Committee and member of the ECMO team of our hospital, and Wei Qiufen, the dean, instructed to immediately start the application for medical assistance to reduce the medical burden of the child in difficulty.
The children's ECMO team quickly assembled and carried out a life-and-death rush during the holidays!
▲The ECMO team performs vascular puncture and catheterization
However, the treatment of ECMO has just begun, Xiuxiu repeatedly suffered from III° atrioventricular block and ventricular tachycardia during the treatment, and the ECMO team and the Department of Cardiology have formulated individualized treatment, bedside ultrasound, non-invasive cardiac function dynamic monitoring of various cardiac function indicators, EEG monitoring system to protect cerebral perfusion, 24-hour real-time monitoring to adjust the treatment plan in time for changes in the condition. With the unremitting efforts of the ECMO team, Xiuxiu's arrhythmia was terminated, her cardiac function gradually recovered, and the ECMO was successfully discharged after 5 days of operation.
▲Vascular surgery sutures the blood vessels during weaning
After 5 days of treatment after weaning ECMO, Xiuxiu's cardiac function gradually improved, and she was transferred to the cardiology department for treatment, and was finally hospitalized for 23 days and cured and discharged.
▲ Xiuxiu's condition improved and she was evacuated from ECMO
In order to help and relieve the difficult patients and reduce the financial pressure of seriously ill children, the Social Work Department of our hospital also linked medical charity resources in many ways to help Xiuxiu apply for the Guangxi Red Cross Foundation's "Care for Women and Children's Health" relief project and the "Medical Road with You" medical social worker serious illness relief project with a total of 20,000 yuan, and the social workers and volunteers of our hospital also helped their families to launch an online fundraising of 29,000 yuan, which greatly reduced the financial burden of Xiuxiu's family in medical treatment and fully demonstrated the public welfare of public hospitals.
Before being discharged from the hospital, Xiuxiu's family told us that she not only felt the noble medical ethics of the medical staff of the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital (Guangxi Children's Hospital), but also experienced the care of the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital for critically ill children from difficult families, so that children with financial difficulties can also receive medical assistance in time and regain their lives. During the whole process, the ECMO team handled the process carefully, communicated in detail, and did not forget to visit Xiuxiu during her recovery, and the family expressed their sincerest gratitude to all the doctors and nurses who rescued Xiuxiu from the hands of death.
Popular science on maternal and child health
01
What is fulminant myocarditis?
Fulminant myocarditis is mainly caused by viral infections and can occur in all ages and genders, but it is more common in children and adolescents, the disease has an insidious onset, deteriorates rapidly, and patients quickly develop heart failure, intractable shock, or fatal arrhythmias, and if not diagnosed and treated early, the mortality rate is high.
02
What are the symptoms of fulminant myocarditis?
Before the onset of the disease, patients may have fever, fatigue, nasal congestion, runny nose, sore throat, cough, diarrhea and other prodromal cold symptoms, but individual differences are large, and more patients can only have low-grade fever, obvious fatigue, loss of appetite or accompanied by mild diarrhea in the early stage, these symptoms can last for 3-5 days or longer, and are easy to be ignored.
Infants and young children who may experience symptoms such as sudden irritability, refusal or difficulty in feeding, pale or gray complexion, clammy skin, listlessness, lethargy, and lack of activity need to seek medical attention immediately. Older children may also complain of palpitations and dizziness.
03
What is the acute treatment and prognosis of fulminant myocarditis?
Patients with fulminant myocarditis should be received or transferred to an intensive care unit as soon as possible for life support and 24-hour special monitoring and care. The monitoring content mainly includes monitoring various vital signs and functions, such as blood pressure, heart rate, respiration, water and electrolytes, coagulation function, etc. Life support treatment includes three aspects: circulatory support, respiratory support, and renal replacement therapy:
Circulatory support: Intra-aortic balloon counterpulsation (IABP) and extracorporeal membrane oxygenation (ECMO) should be used as soon as possible to allow the heart to get sufficient rest, help reduce the burden on the heart, and buy time for its functional recovery;
Respiratory support: When the patient has shortness of breath and strained breathing, respiratory support should be given as soon as possible even if the blood oxygen saturation is normal, so as to reduce the patient's labor load and cardiac work, and improve hypoxia;
Blood purification and continuous renal replacement therapy: all patients with fulminant myocarditis should be treated with blood purification as soon as possible, with the goal of continuous filtration to remove toxins and cytodamaging factors.
Introduction to the Department of Critical Care Medicine
Founded in 2008, the Department of Critical Care Medicine (PICU) of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital is a provincial key critical care medicine clinical specialty in Guangxi, a national pediatric critical and difficult disease improvement project department, the first pediatric advanced life support training base in Guangxi of the American Heart Association (AHA), and a "Youth Civilization" department. At present, there are Xinyang Hospital and Xiangzhu Hospital, and the specialty team of the intensive care medicine department of the two hospitals is composed of physicians and nurses with professional skills and rich clinical experience, and nearly 2,000 critical and difficult cases are admitted every year. The department has built an integrated treatment platform for children's critical illness, including ECMO treatment and transport, bedside intensive ultrasound assessment, multimodal brain function monitoring, blood purification, ventilator and tracheoscopic treatment, rehabilitation training, psychotherapy, critical nutrition assessment and support, etc. The equipment and instruments are advanced, equipped with imported ECMO (extracorporeal membrane lung), imported multi-functional blood purification machine, Jianfan JF-600A hemoperfusion machine, OLYMPUS bronchoscope and workstation, bedside high-end blood gas analyzer, PCT detector, B-ultrasound machine, non-invasive cardiac function monitor, brain function monitor, hypothermia treatment instrument, bed unit disinfection machine and other equipment.
Technical features
1. Respiratory and circulatory function therapy: Extracorporeal membrane oxygenation (ECMO) technology can be carried out to provide timely respiratory and circulatory support and accurate monitoring through accurate early identification and diagnosis of various critically ill children. Our hospital has successfully carried out 5 cases of ECMO in children, and has been successfully cured and discharged, and can be transported under ECMO, and has treated all kinds of severe pneumonia, fulminant myocarditis, encephalitis, shock, drowning, poisoning and other critical and severe children with respiratory and circulatory failure.
2. Bedside rehabilitation and psychotherapy: In cooperation with the Department of Rehabilitation and the Department of Psychology, early individualized bedside rehabilitation training is carried out for critically ill children of all ages, including limb movement and swallowing function training, etc., and 1-to-1 psychological counseling is carried out for critically ill children in the later stage of the disease, which is more scientific and effective adjuvant treatment.
3. 24-hour transport inside and outside the area: Our hospital routinely provides 6 ventilators, ambulances equipped with transport ventilators from premature infants to adults, and professional emergency transport services for critically ill patients by medical staff.
Department contact number:
2860660、2860659 (Xiangzhu Courtyard)
5802051、5802195 (Xinyang Campus)
House call number:
2860500, 2860600 (Xiangzhu Campus)
5802234. 3152428 (Xinyang Campus)
4. Blood purification: As the first unit in Guangxi to carry out bedside blood purification treatment for critically ill children, it carries out various blood purification for critically ill children of all ages, and provides accurate blood purification treatment to critically ill children with acute and chronic renal failure, liver failure, severe water-electrolyte imbalance, acid-base imbalance, volume overload, acute poisoning, autoimmune diseases, hemophagocytic syndrome and other critically ill children.
5. Bronchoendoscopy: As the earliest unit in Guangxi to carry out bedside bronchoscopy and treatment for critically ill children, it carries out bronchoscopy and treatment for critically ill children of all ages.
6. Cardiopulmonary function monitoring: Through bedside intensive ultrasound monitoring, non-invasive cardiac function monitoring, central venous pressure monitoring, invasive arterial blood pressure monitoring and other technologies, real-time assessment and monitoring of cardiac function, blood volume, peripheral blood vessels and lung water conditions are carried out for critically ill children, so as to achieve accurate treatment.
7. EEG function monitoring: We have worked closely with neurology and brain electrophysiology for many years to carry out bedside ambulatory EEG, video EEG, EEG function monitoring, hypothermia brain protection and other examinations, evaluations and treatments. He has rich experience in the diagnosis, treatment and evaluation of severe neurological diseases such as critical status epilepticus, brainstem encephalitis, acute necrotizing encephalopathy and brain injury after cardiopulmonary resuscitation.
8. Nutritional assessment and support: Cooperate with dietitians to conduct nutritional assessment of all critically ill children admitted through the scoring system and nutritional metabolism vehicle, formulate individualized enteral or parenteral nutrition support treatment plans, conduct real-time swallowing function assessment, adjust feeding methods and feeding routes, and improve more scientific and effective nutritional support treatment for children.
9. Basic Life Support and Advanced Life Support Training Center: As the first American Heart Association (AHA) training base in Guangxi, our department took the lead in carrying out AHA basic life support, children's emergency assessment and children's advanced life support courses in Guangxi. Recruit students from all over the district all year round.
Photo丨Zheng Jie, Liang Fengkui, Zeng Kang