Ho Chi Minh City Children's Hospital 1 said that on the evening of June 14, a 12-year-old female patient from Tra Vinh was urgently transferred to Children's Hospital 1, Ho Chi Minh City in critical condition. The child was in a coma, had a heart attack, suffered severe blood loss, had massive bloody diarrhea, and had signs of improving to an alarming level. At this time, the baby's red blood cell count (RBC) is only 10%, less than a quarter of the normal blood volume in the body. If he had been a few hours late, the child might not have survived.
Associate Professor, Dr. Pham Van Quang - Head of the Department of Intensive Care and Anti-Poison, Children's Hospital 1, shared: "The patient was transferred from Tra Vinh in a state of severe shock due to gastrointestinal bleeding and serious blood clotting disorder. Before that, the child had a continuous fever for many days, and on the fourth day, he started having menstrual cramps and bleeding many times. Every time he had a spit, he lost about half a liter of blood."
Although she had been given fluids and anti-shock at a lower-level hospital, the blood loss happened too quickly, forcing doctors to urgently transfer her to a higher-level hospital. At Children's Hospital 1, the whole team entered the race for death. In less than 24 hours, the child was given nearly 10 liters of blood and blood products, more than three times the total amount of blood in the child's body.
In addition to blood transfusion, we have to perform a gas - duodenal endoscopy to find a bleeding spot and use new-generation blood thinners, combined with resuscitation interventions. The damage was unresidential but was widespread bleeding, which was very difficult to control. We can only hold the blood partially and minimize the damage, said Associate Professor, Dr. Quang.
The danger is that dengue fever in severe cases can cause disorders in whole body blood clotting, and in this case, the menstrual factor can make bleeding worse. Under the impact of the disease, the child fell into an uncontrolled digestive bleeding condition, and blood was continuously pumped and lost. After only two days of intensive resuscitation, the patient's vital signs began to stabilize again, and blood clotting function improved. From the fifth day, the child no longer had to expel blood, had a ventilator removed and started practicing eating again.
According to Associate Professor, Dr. Pham Van Quang, this is one of the cases of dengue fever that has had to receive the largest amount of blood since the beginning of the epidemic season. Without abundant blood reserves, coordination between departments, as well as specific medicines, this case would be difficult to cure. We had to mobilize blood, huyet tuong, platelets, and emergency endoscopy and coordinate with a bloodologist for treatment."
Currently, Children's Hospital 1 is treating three cases of severe dengue fever, of which two cases are from Ho Chi Minh City and one case is from Tra Vinh. The cases were all at a severe level of shock, requiring active resuscitation.
Associate Professor, Dr. Quang warned that the rainy season is the time when dengue fever increases sharply. In just the past few weeks, the number of severe dengue fever cases hospitalized has increased every day. Ho Chi Minh City alone has recorded a series of serious cases, exceeding previous forecasts. Parents need to pay special attention, if the child has a fever for two or more days, they need to take him to a medical facility early. Timely detection and treatment can avoid dangerous complications such as shock, gastrointestinal bleeding, and blood clotting disorder".
Since May, Children's Hospital 1 has coordinated with the Ho Chi Minh City Department of Health to deploy training courses for diagnosis and treatment of dengue fever for doctors in the city and the Mekong Delta region, in order to prepare for the epidemic wave at risk of a strong outbreak.
