History healthy, 12-year-old girl with COVID-19 coughing up blood, requiring ECMO

On March 15, Hanoi Heart Hospital said that this unit has just received and treated Children with COVID-19 have a serious change.

A child named NP, 12 years old, from Dong Anh – Hanoi, was admitted to the hospital on March 10. The baby was taken to the emergency room by his family in a state of being unable to speak, having difficulty breathing, coughing up blood, his SpO2 index decreased to 80% (normally over 96%). Prior to that, the patient’s history was completely healthy.

Although this female patient’s 2 rapid COVID-19 test results were negative, emergency department doctors considered this to be a suspected case of severe COVID-19 infection. Therefore, the doctors quickly gave first aid and transferred to the Pediatric Resuscitation Department to conduct intubation. Simultaneously, the pediatric patient was sampled for RT-PCR test with positive results.

Baby P’s condition worsened, the mechanical ventilation index was high, hemodynamic instability, so he had to maintain two vasopressors.

One day after admission, the patient had ventricular tachycardia and circulatory arrest, forcing the doctors to conduct emergency electric shock. Despite being given antiarrhythmic drugs but no response, the patient’s heart function decreased significantly.

Doctors assessed this as a case of severe COVID-19 infection, the pediatric patient had acute myocarditis. The baby was assigned to place ECMO (extracorporeal cardiopulmonary circulation). During the placement of the ECMO machine, the patient still had to receive an electric shock and emergency circulatory arrest.

After 2 days of running ECMO, the patient’s condition improved and was weaned from ECMO. By day 3, the patient was extubated and was able to breathe on his own, hemodynamically stable.