Severe patients with systemic lupus erythematosus with multiple organ failure have improved, and after 8 days and nights of sleepless rescue, respiratory failure | patient | systemic
"Three beds in the emergency room, a patient with systemic lupus erythematosus, fever, respiratory failure, requesting consultation." A text message popped up in the emergency consultation group of the Rheumatology Department of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The rheumatology consultant who was on ward rounds immediately rushed to the emergency room of the southern hospital. A 67 year old female with systemic lupus erythematosus, who had been taking glucocorticoids and immunosuppressants for a long time, experienced sudden high fever and breathing difficulties. This is the most critically ill patient with rheumatism. The emergency rheumatism green channel quickly opens, and the patient is immediately sent to the first rheumatism critical care unit in China: ECMO, ventilator, and CRRT. After 8 days and nights of rescue, the patient gradually improved.
Severe lung infections are the most deadly, and these medical teams relay rescue
Severe lung infections are the deadliest, and these medical teams are working together to rescue them
When the consulting doctor rushed to the emergency room and looked at the beating numbers on the patient's monitor, his heart sank. "Severe lung infection." This is fatal for immunosuppressive rheumatic patients. A series of emergency measures such as respiratory support, pathogen identification, active anti infection, and primary disease treatment were all used at the first time. However, due to the severity of the condition, the patient developed heart failure and acute renal failure. At this time, the tracheal intubation ventilator assisted breathing and 100% pure oxygen inhalation, and the patient's oxygen saturation was still less than 80%. Pulmonary imaging also confirmed widespread diffuse exudation in both lungs.
"There is no choice! Go to ECMO." Wang Xiaodong, Deputy Chief Physician of Rheumatology, immediately initiated the multidisciplinary SOS treatment process for critically ill patients. Chief Cardiovascular Surgery Physician Wang Weijun and Deputy Chief Physician Liu Jidong rushed over, and Emergency Department attending physician Xie Cuiying cancelled the flight. After one hour of intensive operation, the Rheumatology Intensive Care Team, Emergency Team, and ECMO Team successfully connected and operated V-V ECMO. The patient's oxygen saturation improved, and their vital signs gradually stabilized.
In the following days, the Renji Rheumatology and Emergency Intensive Care Team worked together to carry out CRRT renal replacement therapy, monitor input and output volume, cardiac output index, blood gas, coagulation indicators, and adjust treatment plans in a timely manner... After 8 days and nights of effort, ECMO, ventilators, and CRRT were gradually withdrawn, and the patient gradually improved. Currently, they have been transferred to the general ward of the Rheumatology Department for further treatment.
After the first aid line was connected, the patient's hope was reignited
Critical care is the last line of defense to protect the patient's life, and is particularly important for rheumatic patients with multiple organ involvement. Taking systemic lupus erythematosus as an example, patients may experience life-threatening organ dysfunction due to disease activity or immunosuppressive therapy, accounting for 1% to 30% of the total incidence of systemic lupus erythematosus. Severe cases require admission to intensive care units, with a higher mortality rate.
Strive for every minute of life for critically ill patients. The emergency department of Renji Hospital's South Campus has taken the lead in establishing an emergency rheumatism green channel, achieving rapid transportation and enabling patients to receive timely and efficient treatment from the rheumatism department team as soon as they seek medical attention. Last year, this lifeline for rescue was once again upgraded. Under the planning and coordination of the director of the Rheumatology Department, Ye Shuang, the Rheumatology Department established the first rheumatic critical care unit in China, integrating life support technology for multi organ system failure and cutting-edge immune targeted diagnosis and treatment methods.
