Yangtze River News March 10 (Reporter Wang Kaining) At around 2 pm on March 8, in the ICU (Intensive Care Unit) of Guanggu District, Tongji Hospital, Huazhong University of Science and Technology, the doctor successfully removed the ECMO (in vitro membrane) Pulmonary oxygenation), becoming the first patient with new coronary pneumonia in the state to be awake under ECMO. As of March 9th, Tongji Optics Valley Hospital has successfully separated three critically ill patients from the assistance of ECMO within two weeks and achieved 100% survival.

Lao Jin is a pharmacist at the Department of Pharmacy of Wuchang Hospital. He was infected with new crown pneumonia at work. He was admitted to the Guanggu District of Tongji Hospital on February 16th. A week later, his condition worsened and he was transferred to the ICU for tracheal intubation. However, the effect was not satisfactory. On February 28, Lao Jin suffered a sudden respiratory arrest.

"The situation is urgent." Zhou Ning, a member of the Heart Guard Unit of the Guanggu District of Tongji Hospital, has been stationed in the ICU since February 14. During the rounds inspection on February 28, Lao Jin suffered respiratory arrest due to airway obstruction, a sudden drop in heart rate, and blood pressure disappeared. Zhou Ning immediately performed chest compressions for Lao Jin and successfully resuscitated him. He served him on March 1 ECMO implantation.

Most critically ill patients require ventilator-assisted treatment, but not many patients with tracheal intubation can successfully extubate, and many patients are unable to return to the sky even after they have finally entered ECMO. Lao Jin's sudden respiratory arrest left Zhou Ning thinking: Should critically ill patients have to choose tracheal intubation ventilator-assisted ventilation? In the following treatment, he tried to adjust Lao Jin's oxygen supply concentration, support pressure, number of assists and other ventilator parameters to the minimum, and found that Lao Jin's blood oxygen saturation was still maintained at 100%.

Doctors are withdrawing ECMO from patients in the ICU of the Guanggu District of Tongji Hospital. Photo by reporter Jin Zhenqiang

"This shows that there is still room for improvement in the treatment strategy of the critically ill patients we are currently using." Zhou Ning proposed at the case analysis meeting that Lao Jin could first be removed from the trachea and then removed from ECMO. On the one hand, patients can stay awake after extubation, and retain spontaneous breathing, cough reflex, and sputum excretion. On the other hand, early extubation can avoid secondary lung infections and ventilator-related pneumonia caused by airway opening. And lung injury.

Zhou Ning's proposal was endorsed by Li Shengqing, the leader of the fourth column of Huashan Medical Team in charge of ICU. On March 5, after pulling out the trachea for Lao Jin, they found that Lao Jin's blood oxygen saturation was still stable at 95% -100%. On March 8th, Lao Jin successfully quit the assistance of ECMO in a sober state, and as of the press release, his vital signs were good.

"In the two ECMO patients before Lao Jin, we all removed ECMO first and then extubated." Zhou Ning explained that patients with new coronary pneumonia had many sputum plugs after tracheal intubation, which were very dry and difficult to suck out. Lao Jin's rehabilitation means that some patients may not need tracheal intubation to assist ventilation. “If non-invasive ventilator-assisted ventilation is still unsatisfactory, you can consider implementing ECMO directly. Because ECMO can completely replace the oxygenation function of the lungs, it can allow the lungs to fully rest, and the assistance time is longer than that of tracheal intubation ventilator ventilation. To earn more time for patients. "

Since February 9th, the ICU of the Guanggu District of Tongji Hospital has received more than 60 critically ill patients, of which 20 patients have become mild. "The successful treatment of 3 patients assisted by ECMO has greatly encouraged us. Next, we need to explore more feasible treatment strategies and form a replicable treatment plan for critically ill patients so that more people can survive." Zhou Ning Say.