On November 20, 2020, Jiang Mingyan (Director ofXiangtan Central Hospital RICU Department) received an emergency call from Zhao Jianghong(Director of Hunan Cancer HospitalICU Department): a 39-year-old patientcritically ill with cervical cancer and pulmonary obstructionfrom Xiangtan was admitted to Hunan Cancer Hospital the day before. Upon hospitaliztion, the patient was immediately transferred to ICU due to sudden shortness of breath, poor SpO2, and unstable condition after a severe cough. However, the patient didn’t improve even with a series of treatments, which include but not limited to getting oxygen, connecting the ECG monitor, and establishing venous access, rapid rehydration, catheterization, and arterial catheterization.The patient's SpO2was showed 70% with worsen cyanosis and decreased blood pressure. The situation was very dangerous.
Regarding the situation of the patient, the ICU team decided to refer to ECMO therapy and contacted the ECMO team of Xiangtan Central Hospital. After the call, the ECMO team from Xiangtan Central Hospital assembled immediately and hurried to Changsha with equipment.
On that night, the ECMO team of Xiangtan Central Hospital and the ICU team of Hunan Cancer Hospitalfought overnight to get the patients successfully on ECMO. The SpO2increased from 70% to 100%.
On the afternoon of November 21, the patient was safely transferred to Xiangtan Central Hospital. On the afternoon of November 22, the patient's regained consciousness and was took off the ventilator afterrehabilitation training followed by high-flow oxygen therapy.
The ECMO team continued to monitor the patientday and night, and conducted multiple consultations and discussions of the whole hospital. Every hour, medical staff would report the latest situation of the patient in the WeChat group.
As the ECMO runs longer, the risk of patient gets infection increases. After another consultation, the president Zeng Jianping decisively instructed to adjust the treatment plan. The effect of the new treatment was obviousas the platelet did not continue to decrease from the next day. With the full support of 24-hour CRTT from the Department of Blood Transfusion and Department of Nephrology, the patient's RBC and platelet count indicators also returned to normal values.
On December 20, after being admitted to the hospital for a whole month, the vital signs of the patientfinally stabilized and she was transferred to the general ward. After nearly 2 months of treatment and care, the patient recovered and was discharged from the hospital on January 17.
In 2020, the RICU Department completed 10 ECMO treatments inside and outside the hospital, saving 8 lives.
