The Six-Year-old male child with special needs had signs of viral pneumonia, fever and respiratory difficulty when he was brought to Columbia Asia Hospital Whitefield. Initially this specially challenged kid was on oxygen support with antibiotics and nebulisations but he wasn’t getting better and was unable to express how he was feeling since he was a special child and had to be paid extra attention.
So hewas shifted to a ventilator support. Even there, his ventilator support pressure and resistance was going very high to a stage that it was life threatening. Looking at the critical condition of their child, the parents were shattered. It seemed like their life came to a standstill, because they were extremely connected to this kid looking after its daily needs.
The parents at any cost weren’t ready to compromise on the any requirements for the treatment of the special kid, and were willing to go to any extent to save their child.
Then it was decided to put him in Extracorporeal membrane oxygenation (ECMO) or a heart line machine whichtakes out blood fromthe larger vein, connecting to the machine, oxygenating the blood. This blood aids in giving rest to the lungs once it flows back into the body. Five to seven days is the usual duration for the lungs to get better in this kind of situation.
This device is traditionally used to support adults & children awaiting heart transplant or to support cardiac function post-cardiac surgery. Miraculously it worked in this case and the team at Columbia Asia Hospital Whitefield did veno-venous ECMO where blood was drained from a large cannulainserted in the neck vein. Gradually his lung function improved and ECMO was decannulated after 6 days of continuous run.
According to Dr. Senthil Kumar, Consultant – Paediatric, Neonatal & Cardiac Intensivist,Columbia Asia Hospital, Whitefield “Pollution, low quality of food, weather and seasonal transformation in Bangalore influences these ailments, particularly in children who are immunodeficient, or have some kind of lung or heart issue. These days, majority of kids are Vitamin D deficient due to lack of going out in the sunlight, staying in AC, this has impacted a lot on the immunity. The immunity reduces due to the effects of virus in the body, lack of proper nutritional intake. Antibiotics as such do not supress it, though unnecessary excessive usage of antibiotics might create a resistance on the body”.
The child was discharged on 14th day of admission making a nearly 100% lung recovery without any complications. This is a rare case scenario in India where a special child had a successful outcome for severe pneumonia after veno-venous ECMO.
The parents were grateful that their special child who was unable to express the difficulties, recovered in a magical way, and they were touched with the way that the doctors at Columbia Asia Hospital Whitefield treated the child with special care, implementing unique treatment method.
Advisory on Pneumonia – Do’s and Dont’s parents should take care off
To prevent such a severity, one needs to lookout for the signs and symptoms of Pneumonia.
Pneumonia is diagnosed by fever, fast breathing or chest wall in drawing during inspiration, often preceded by cough & running nose with further confirmation by X-ray & blood investigations. Very severely ill child may be unable to feed or drink, become lazy & drowsy, may also turn blue, gradually progressing to respiratory failure & coma.
Early recognition and treatment leads to better outcome. Hospitalization is required in case of age <6 months, immune compromised state, moderate to severe respiratory distress requiring oxygen support or if not responding to oral antibiotic therapy. If viral pneumonia is suspected, it is reasonable to withhold antibiotic therapy, especially for those children who are mildly ill & are in no respiratory distress.
Regular handwashing, usage of mask may help preventing it to a certain extent. Students in schools with cough and cold should be strictly asked to stay at home. As the droplets from sneezing or coughing, if comes in touch with an immunosuppressed individual, with chronic lung issues, it is very likely to get them infected.
For adults, like Geriatric patients, they can easily catch the infection and also spread it out easily. If the high grade fever persists more than four days along with breathing difficulties, continuous coughing, discoloration of fingers and tongue showing low oxygen levels and causing altered behaviour, sunken lower chest, inability to speak or eat properly, low output of urine are the usual red flag signs which immediately need the doctor’s consultation or admission to a hospital.