Diarrhea causes multi-functional failure? After 200 hours of ECMO, the heart is back to work

Recently, 39-year-old MrYue (pseudonym) from diarrhea to shock, multi-organ failure, was transferred to the blessing hospital ICU treatment, but the situation is not so simple, severeinfection, septic shock, acute kidney failure, clotting dysfunction, transverse muscle dissolution, severe myocarditis, cardiac arrest, CARDIOpulmonary resuscitation after the myocardial contraction weakness ..Any serious illness is enough to kill MrYue ACEthe complex and strange illness, the rescue process is very thrilling, ICU team overnight for MrYue connected to THE VA-ECMO (in vitro membrane pulmonary oxygenation) treatment, only to stabilize the diseaseAfter more than 200 hours of ECMO support, MrYue's heart "to work" again, and finally "tiger mouth relief.""if elsewhere, life may be handed down", the family is very grateful to the team and ECMO in time to rescueSo far, ECMO in our hospital in the treatment of critical treatment of high-gloss to add anotherhospital into severe shockmulti-organ failure, complex condition of the manMay 15 at about 13 o'clock, MrYue from the lower hospital, when the person has been severely shocked, disoriented, according to the family account, the patient diarrhea for several days, high fever to Tests found that the blood potassium is only 1.8mmol/L, and the infection index is higher than the upper limit of the test, at the same time there are acute renal failure, transverse muscle dissolution, severe arrhythmia , the situation is very unfriendly, immediately sent to the ICU rescue anti-infection, maintain blood pressure, tracheostomy, blood purification, intravenous potassium, a series of rescue measures in an orderly manner However, the patient's arrhythmia is getting worse, and blood pressure cannot even be measured, and the situation is critical ventricular fibrillation and cardiac arrest twice snatchthe door men's heart contraction is very poor " patients from the beginning of the ventricular tachycardia, into ventricular fibrillation! "The ventricular fibrillation represents cardiac arrest, said Dr ICU Li, after the successful electro-defibrillator patient successfully re-run, we thought he would escape, however, soon after the patient's heart directly stopped 's condition is very strange, the team dare not have a trace of slack, fortunately 3 minutes later, after advanced CPR, the patient resumed the independent heartbeat Despite escaping again, the team found an extremely serious problem: the patient's heart contraction function was very poor Bedside heart color super show: the heart only slight creep, can not effectively shrink the blood heart problems, just like engine failure, conventional treatment of critical care is nowhere to make, patients may lose their lives at any time, ECMO treatment is the only accurate treatment night on THE ECMO, CRRT machine heart, kidneys on the "replacement" was already 16 in the early morning, icU team quickly drew groups for patients to establish vascular pathways, flushing tubes, connections At 2 a.m., the VA ECMO, known as "artificial cardiopulmonary", officially operates, the venous blood is drawn from the patient's body, the membrane pulmonary oxygenation, and then through the drive pump back to the artery, the patient's heart can finally get rest Because the kidneys are already "overwhelmed," the team also used renal replacement therapy (CRRT) to replace the severely impaired kidney "work." "This is the most serious treatment that ICU has experienced this year," said Liu Yunsong, director of the ICU, not only suffered from damage to almost all of its vital organs, but also suppressed the system of , and the ICU team was able to use various support tools to maintain the patient's heart, lungs, kidneys and other important organ function, to find the cause and restore the organ function find severe infection, paralysis killer multidisciplinary diagnosis and treatment help, life-saving and rehabilitation
May 18, the patient's blood culture E1 group of salmonella, diarrhea "murderer" found Originally, Mr Yue nearly a month because of work fatigue and physical discomfort, self-taking a variety of antibiotics and anti-cold drugs, resulting in low immune function The ill-fated food before the illness led to infectious diarrhea Under the increase of immunophospha, diarrhea and infection, severe shock, acute kidney failure, clotting dysfunction, transverse muscle dissolution and severe myocarditis are caused by a series of chain reactions, followed by malignant arrhythmia and cardiac arrest after nearly 200 hours of ECMO treatment, and the care team day and night care, on the morning of May 25, Mr Yue finally successfully withdrew, the heart "to work" back to normal operation On 30 May, he successfully exited the ventilator and gradually recovered his kidney function, withdrawing from CRRT treatment on 1 June June 1, after all analgesic sedatives were discontinued, the ICU team accidentally found that the patient's muscle weakness and limbs were in a state of soft paralysis Rapid re-examination, through waist wear, magnetic resonance examination, as well as neurology director Zhang Xiong, radiology Director Peng Guangming, the paralysed killer is also now - ICU acquired myopathy Patients suffer from severe infections and multiple organ failure, which can lead to multiple nerve and muscle damage, leading to limb weakness and prolonged recovery to do so, the ICU asked the rehabilitation team to step in early and train for them patients' condition is improving, muscle strength is gradually recovering, has now been transferred to the community hospital to continue rehabilitation, "a lot of progress!" The family said with joy what is ECMO, which also performed well in the treatment of the new crown in critical condition? ECMO (Extracorporeal Membrane Oxygenation), commonly known as "artificial lung", works by drawing the patient's oxygen-inshorted intravenous blood out of the body, allowing the blood to be fully integrated with oxygen in the membrane and then pumped back into the body There are two types of ECMO: intravenous-ven (V-V) ECMO and venous-arterial (V-A) ECMO The former returns the oxygenated blood to the veins, while the latter returns to the arteries, supporting the heart in addition to supporting the lungs (see below) ECMO is equivalent to the lungs and heart outside the body, providing continuous oxygen and circulatory support to patients, temporarily taking over the daily work of the damaged lungs and heart, giving it adequate rest As the condition improves, doctors will gradually reduce the amount of blood that is oxygenated through ECMO until the patient can withdraw from the ECMO ECMO technology is the embodiment of the level of critical treatment in a hospital or a region In this new crown pneumonia outbreak occurred before the domestic only more than 400 ECMO, can be said to be very "excellent", in 2018 China a total of 3923 cases of ECMO reported registration THE WHOLE PROCESS OF ECMO TREATMENT, INCLUDING THE PLACEMENT OF PIPELINES, ANTICOAGULANT, MONITORING AND OTHER LINKS ARE FINE ACTIVITY, THE NEED FOR A SPECIAL ICU OR IN VITRO CIRCULATION TEAM
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