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                                                          Baby of Vijaya Lakshmi

                                                          Donated Rs 50,000/-

Final Diagnosis:
Extreme Preterm (28 Weeks) Extreme Low Birth Weight (ELBW) / Intra Uterine
Growth Restriction (IUGR)
Respiratory Distress Syndrome (RDS) Received Surfactant & Invasive Ventilatory
Support initially and currently on Non-Invasive Ventilatory support
Severe Sepsis / Shock / Coagulopathy / Thrombocytopenia
Neonatal Jaundice

Course:
Baby of Vijaya Lakshmi is a 28 weeks premature baby weighing 985 grams, born
to a 32-year-old mother after 7 years of marital life & 2 previous abortions. During
this pregnancy she had severe pregnancy induced hypertension (PIH) on multiple
antihypertensive medication. Antenatal scans also revealed a significant fetal
growth restriction.
The Baby was delivered early (Due to Fetal compromise) at 28 weeks of gestation
by emergency LSCS on 7 th October 2019 at 3:45 pm. The weight was 985 gm at
birth and he was noticed to have poor respiratory efforts, so was intubated /
resuscitated / ventilated and shifted to Little Stars Children’s Hospital.
Baby had severe Respiratory Distress Syndrome (RDS), received 1 dose of
surfactant and extubated to NIV-PC. On Day 1 of life, baby had poor perfusion
with metabolic acidosis, needing inotropic support. 2D Echo revealed severe
Pulmonary Artery Hypertension (PAH). The baby also had severe sepsis (CRP-69)
with a low platelet count and coagulopathy for which antibiotics were upgraded,
received SDP x 2 transfusions and 1 FFP transfusion.
On Day 2 of life, baby had high Jaundice TSB (17.5) with no major incompatibilities
& received intensive phototherapy. Currently the baby is tolerating oro-gastric
feeds (Expressed Breast Milk) and stable on non-invasive ventilatory support &

Intensive Care management. Baby needs at least 8 weeks of NICU stay until a
corrected gestational age of 36 weeks.


 

 

 

 

 

 

Johny Vishvaas

Donated Rs 50,000/-

Johnny vishvaas, 2yrs old boy case of severe pneumonia, left upper lobe emphysema. (s/p decortication,
sepsis, Anemia, failure to thrive). He is on IV linezolid IV cefepime & Imipenem.
Admitted with Complaints of Cough and cold since 4weeks, fast breathing since 3 days.
1. Johny parents took the child to Shivraram hospital 1st near chintal for treatment. Went for 1
month& IV injection was given in the morning and evening every day. Even though there was no
improvement seen, the child was shifted to another hospital.
2. At the 2nd hospital he got admitted for 3 days, baby was suffering from severe problems and he
was extremely sick and fragile.
3. They shifted him to a 3rd hospital, (Happy Children’s Hospital in Chintal for half day then later
was referred to Little Stars Children’s Hospital.
4. He had Decortication of left upper lobe. He is doing better now on Room air not requiring
oxygen. Oral intake is better On IV medications.


                        Sowjanya

Donated Rs 50,000/-

Case Summary – Baby D.SOWJANYA

FINAL DIAGNOSIS;
1.SEVERE DENGUE HEMORRHAGIC SHOCK
2.ARDS WITH PULMONARY EDEMA
3.LIVER DYSFUNCTION WITH COAGULOPATHY
4.SEPSIS

Issues & Course of the Illness:
1.Respiratory System – ARDS / VENTILATION: Baby Sowjanya presented to the
Emergency Room in a hypoxic &irritable state with severe pulmonary edema,
Pulmonary Hemorrhage, Respiratory Failure and Circulatory SHOCK. She was
immediately fluid resuscitated, intubated and shifted to the PICU for further
ventilatory & intensive care management.
She needed extremely high pressures to maintain oxygen saturations on the
conventional ventilator. She was also noted to have significant bouts of
pulmonary hemorrhage needing High Frequency Oscillatory Ventilation (HFOV) to
sustain life. She gradually settled on HFOV with high pressures & 100% FiO2.
Chest X-ray & arterial blood gases suggested pleural effusion, pulmonary edema
and Severe ARDS
Over the next 5 days she has hemo-dynamically stabilized, pulmonary
hemorrhage has subsided & was shifted to conventional ventilation and
subsequently extubated to Non Invasive Ventilation.
2.Cardio Vascular System: Baby Sowjanya was admitted with significant
circulatory failure & Severe SHOCK needing multiple fluid boluses &  inotropes to

maintain blood pressure & peripheral perfusion. Despite repeated crystalloid &
colloid infusion and blood products she needed up to 4 inotropes to maintain her
hemo-dynamic stability. Gradually she improved with intensive care management
and her cardiac support could be successfully weaned.
3. HEPATIC DYSFUNCTION & Severe COAGULOPATHY: Liver Enzymes were
grossly elevated & Coagulation Profile was significantly deranged.
In view of recurrent pulmonary hemorrhage & deranged coagulation profile,
Vitamin K, Fresh Frozen Plasma, Cryo-precipitate & Single Donor Platelets were
given repeatedly as per the need. Child also needed I unit of Packed Red Cells as
the Hemoglobin percentage dropped to 7.5 gm%.
Liver enzymes, bilirubin & coagulation parameters have gradually improved
clinically and no further bleeding was noticed.
4.SEPIS: Sowjanya was also noted to have a high CRP & concurrent SEPSIS, which
gradually responded to IV antibiotics & intensive care management.
Sowjanya has gradually recovered from all the above systemic difficulties and was
successfully discharged home without any residual deficits.