ECMO saves girl who had cardiac arrest for 60 minutes from death’s door

On July 4, Associate Professor, Dr. Pham Van Quang, Head of the Department of Intensive Care and Anti-Poisoning, said that a 6-year-old patient from Long An fell into cardiogenic shock, arrhythmia and then cardiac arrest after 3 days of abdominal pain and vomiting. Doctors intubated, performed external cardiac massage and raised the red alert to perform emergency ECMO. This is an extracorporeal membrane oxygenation technique that can replace the function of the heart and lungs and is used for severe, life-threatening patients.

After the intervention, the patient’s hemodynamics were temporarily stable, but the arrhythmia required additional cardiac support, antiarrhythmic drugs, and continuous blood filtration. Doctors used hypothermia techniques with anti-cerebral edema drugs to protect the brain. In addition to acute myocarditis, the patient also had severe pneumonia and sepsis.

The patient’s heart gradually recovered, the myocardial contractility function was good and the patient was successfully removed from ECMO on the 8th day. After half a month of treatment, the patient was awake, removed from the ventilator, normal indicators, eating well, no brain sequelae. The girl is expected to be discharged early next week.

ECMO has been performed by Children’s Hospital 1 since February 2019 with the transfer of technology from Cho Ray Hospital. To date, the hospital has been able to intervene on all children, including newborns. The smallest successful case weighed 3.1 kg (7 days old). This technique is applied to many diseases such as myocarditis, congenital heart surgery, respiratory failure in patients with severe pneumonia, anaphylactic shock, aspiration pneumonia due to lamp oil… Of which, nearly 40 cases were acute myocarditis, with a survival rate of 80%.

“Thanks to the application of this advanced technique, many cases of acute myocarditis have been saved, while previously most of them were fatal,” said Associate Professor Quang.

Myocarditis is a type of inflammation of the heart muscle caused by a virus, damaging heart muscle cells, reducing the force of myocardial contraction, leading to circulatory collapse, causing the heart to dilate, the heart muscle to contract very weakly, and increasing cardiac enzymes due to the release of damaged heart muscle cells. The disease is difficult to detect when the initial symptoms are very vague, easily confused with other diseases such as colds. Some children have no previous symptoms, but the disease progresses very quickly, is severe, and has a high risk of death. If they survive, they are likely to develop heart failure or arrhythmia later.

Children with mild fever, fatigue, headache, vomiting, abdominal pain, pale complexion, pale hands and feet, pale fingernails, fainting, chest pain… should be quickly taken to a medical facility with a pediatric specialist for examination, early diagnosis of myocarditis and appropriate treatment.

Prevent diseases by limiting children’s contact with adults who have contracted viral diseases. Provide children with adequate vitamins and minerals. Vaccinate children against diphtheria, influenza, rubella, mumps, etc. to increase their resistance to disease. School-age children should practice the habit of washing their hands before eating and after using the toilet.