The female patient (1998, Vinh Long), 2 days before had a fever, headache, sore throat, muscle pain, and no improvement after taking medicine. While taking her child to the Can Tho Children's Hospital for a check-up, the patient continued to feel tired and had difficulty breathing, so she was admitted to a local hospital in critical condition. The patient was initially treated and quickly transferred to Can Tho Central General Hospital.
The patient was admitted to the hospital with respiratory failure, coma, balloon strangulation, agitation, restlessness, rapid breathing, very rapid heart rate, pale skin, cold extremities, severe metabolic acidosis, low blood pressure, and was using high doses of vasopressors.
Test results showed hypokinesia of almost all heart walls, echocardiography showed severe reduction in ejection fraction EF to 20% (normal ≥60%). Diagnosis of acute myocarditis complicated by ventricular arrhythmia - cardiogenic shock, cardiac arrest, successfully resuscitated - multiple organ failure.
At the same time, two teams performed: temporary pacemaker placement, ECMO-VA technique (extracorporeal membrane oxygenation) was performed to support the recovery of heart and circulatory function for the patient. Continued mechanical ventilation, maintenance of vasopressors, systemic adjustment, sedation, pain relief, muscle relaxants, antibiotics, arrhythmia treatment, increased myocardial contractility, and continuous blood filtration for the patient.
After 45 minutes of completing the 2 techniques, the patient's arrhythmia and hemodynamics improved significantly. The patient also received plasma exchange due to severe liver failure, biliary obstruction, intensive medical treatment, nutritional support, physical therapy, etc. After the 5th day of ECMO intervention, the patient's condition gradually improved, blood pressure was stable, heart rate was regular, the dose of vasopressors was gradually reduced, and myocardial contractility improved well.
On October 30, the patient was successfully weaned off the ECMO system, weaned off the ventilator, removed the endotracheal tube, and had good lung ventilation. Currently, the patient is awake, responsive, vital signs are stable, heart rate, echocardiogram myocardial contractility has returned to almost normal, and organ tests are gradually stabilizing.
Dr. Duong Thien Phuoc - Head of the Department of Intensive Care and Anti-Poison - informed that the success of the case was a combination of many factors. The patient's spectacular recovery brought great joy to the constant efforts and determination of the doctors and nurses at the hospital to save the patient's life.
