Vinmec Hai Phong successfully treats 93-year-old woman with multiple organ failure and many dangerous diseases

Triple illness" case with high risk of death in a 93-year-old patient

Ms. Trinh Thi Tue (93 years old, Hai Phong) was taken by her family to Vinmec Hai Phong for emergency treatment in a state of rapidly increasing shortness of breath, whole body edema, very little urination and exhaustion.

According to the patient's family, Ms. Tue has a history of diabetes for more than 30 years. About 5 years ago, her health declined when chronic kidney failure, high blood pressure, chronic gout, dyslipidemia and prolonged anemia appeared.

In 2022, the patient was directly monitored and treated at Vinmec Hai Phong by MSc. Dr. Vu Thi Duyen - endocrinologist. Thanks to good blood sugar control and underlying diseases, the patient's health remained relatively stable for many years. Therefore, when abnormal signs appeared, the family continued to take the patient to Vinmec Hai Phong for treatment.

However, two days before admission, the patient developed rapidly increased shortness of breath, edema all over the body, and urinary retention was noticeable. When receiving the patient, doctors assessed that this was a very serious condition due to many important organs losing compensation at the same time. The patient showed signs of severe heart failure, severe kidney dysfunction, anemia, electrolyte disorders, and progressive pneumonia.

Tests recorded high kidney function index, hyperkalemia - a condition at risk of dangerous arrhythmia - and a sharp increase in the indicator reflecting heart failure. Meanwhile, diagnostic imaging showed that the patient had bilateral pleural effusion, spreading inflammatory lesions in the lungs, partial collapse of the left lung base and little pericardium fluid.

Notably, the bedside ultrasound and diagnostic imaging system has helped the team quickly assess the condition of the heart and lungs and the level of fluid retention immediately upon admission without having to move the patient much. This is an important factor for elderly patients with weak physical condition and rapid progression of respiratory failure.

According to BSCKII Tran Van Quy, Head of the Department of Medical Examination & Internal Medicine, this is a case with a very complex treatment level due to many diseases interacting and exacerbating each other.

Heart failure causes fluids to stagnate in the lungs, causing shortness of breath and respiratory failure. Meanwhile, kidney failure prevents the body from excreting fluids and potassium, making circulatory overload worse. Pneumonia continues to reduce blood oxygen. With a 93-year-old patient, the ability to store organ function is very low, so the risk of multiple organ failure and death is very high," the doctor analyzed.

Multidisciplinary coordination to simultaneously control the heart, kidneys and respiratory system

Faced with the risk of rapidly progressing multiple organ failure, Vinmec Hai Phong has activated a multi-specialized consultation between Endocrinology, Internal Medicine, Cardiology and Emergency Resuscitation to develop an optimal treatment strategy for patients.

The treatment team includes MSc.BS Vu Thi Duyen (Department of Endocrinology), BSCKII Tran Van Quy (Head of Department of Medical Examination & Internal Medicine) and MSc.BS Bui Tien Dat (Department of Emergency Resuscitation).

According to doctors, treating elderly patients with multiple underlying diseases cannot approach each individual pathology but must comprehensively assess the overall condition of the patient at each time.

Using strong diuretics to reduce the burden on the heart can quickly worsen kidney function. Conversely, if fluid control is not appropriate, patients are at risk of acute pulmonary edema and severe respiratory failure. Meanwhile, electrolyte and blood sugar disorders in older adults always pose a risk of dangerous complications.

Patients are simultaneously deployed with many specialized treatment measures such as oxygen support, using diuretics to control fluid retention, antibiotic treatment for pneumonia, strict blood sugar control and close monitoring of heart, kidney and electrolyte functions.

Throughout the treatment process, the ultrasound and bedside diagnosis system continues to support doctors to monitor the development of pleural effusion, lung condition and treatment response in real time to adjust the appropriate regimen.

According to MSc.BS Vu Thi Duyen, treating elderly patients with multiple underlying diseases requires doctors not only to control acute diseases, but also to balance all organ functions.

Elderly patients often no longer have much ability to reserve organ functions, just one uncontrolled disease can lead to a series of other organs collapsing. Therefore, the most important thing is to closely monitor the progression of the disease, personalize treatment and coordinate multi-specialty to make appropriate decisions at each time," the doctor said.

After a period of intensive treatment, the patient's condition improved significantly: no longer shortness of breath, completely reduced whole-body edema, no longer chest pain, no hypoglycemia attacks and gradually stabilized indicators. When discharged from the hospital, the patient was awake, vital signs were stable and could resume activities.

The success of the case shows the ability to treat complex medical cases at Vinmec Hai Phong, especially in the group of elderly patients with multiple background diseases - a group with a very high risk of complications and death if not monitored and intervened in time.