Recently, the Emergency and Resuscitation Department of City Children’s Hospital received 1 case of a child living in Thanh Binh, Dong Thap who was hospitalized in a state of Dengue hemorrhagic fever. Take the history of the child with NMD. 7 months old, male, 3 days sick, low fever, repeated loose stools, generalized convulsions, was admitted to a private general clinic, treated with oxygen, anticonvulsant with diazepam, then transferred to Children’s Hospital City. On the way to the City Children’s Hospital for about 30 minutes, the child convulsed continuously.
At the Emergency Department, the child had cyanosis of the lips, was in shock, the pulse was difficult to catch, the blood pressure was difficult to measure, the NS1Ag test was positive, and the child was given respiratory support and anti-shock treatment according to the protocol. The condition progressed severely, the child was in prolonged shock, accompanied by liver damage (liver enzymes > 4000 units/L), coagulopathy, gastrointestinal bleeding, large pleural effusion causing severe respiratory failure. blood transfusion, fresh frozen plasma transfusion, cryoprecipitate, platelets, laparotomy, pleural decompression.
After that, the child’s breathing worsened, chest X-ray image showed bilateral diffuse severe lung injury, severe acute respiratory distress syndrome (ARDS) should be consulted. hospital and perform extracorporeal membrane oxygenation (ECMO). Children are also treated to support the liver, adjust water and electrolytes, metabolic acidosis, antibiotics, antipyretic, nutrition. Results after 2 weeks, the child’s condition improved gradually, the child was weaned from ECMO, then weaned from the ventilator, non-invasive ventilation, oxygen through the cannula, and then the child was able to breathe on his own with air. The child was discharged after 49 days of hospital stay. Children are guided to take care at home, periodically follow-up and re-examination to record the child’s well-developed condition
Doctor 2 Nguyen Minh Tien
City Children’s Hospital