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Girl, 16, was losing COVID-19 fight. Then a bold step helped
Posted on: April 24, 2020 at 20:50:53 CT
JeffB MU
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save her life.
By Lisa L. Colangelo
lisa.colangelo@newsday.com @lisalcolangelo
Updated April 23, 2020
https://www.newsday.com/news/health/coronavirus/cohen-and-extracorporeal-membrane-oxygenation-1.44034780
Sixteen-year-old Karla Duarte was on a ventilator at Cohen Children’s Medical Center on April 4, battling COVID-19, the disease that was weakening her lungs. And she was getting worse.
Doctors already had tried conventional therapies and experimental drugs before deciding to take a much bolder step. They put Karla on an extracorporeal membrane oxygenation (ECMO) device that took over the function of her lungs and added extra oxygen to her blood.
While the ECMO has proved successful treating people with serious pneumonia as well as heart and lung problems, the hospital had not used it on a juvenile patient with COVID-19, the disease caused by the coronavirus SARS-CoV-2.
“She was failing,” said Dr. James Schneider, chief of pediatric critical care medicine at Cohen Children’s Medical Center. “She was a previously healthy young lady … it was worth trying.”
The device’s therapy, which has been in use for decades, reportedly has been used in other hospitals to treat adult patients with COVID-19. The U.S. Food and Drug Administration earlier this month cleared it for use on patients suffering extreme conditions from the virus.
Karla was discharged from the New Hyde Park hospital Sunday to rousing cheers from Schneider and the rest of the staff. They believe she is one of the first pediatric cases successfully treated with an ECMO machine.
“I was crying so much,” Karla said about her spirited send-off from the hospital. “I was so emotional, I couldn’t speak. They saved my life.”
The teen, who lives in Queens Village, isn’t sure how she contracted the coronavirus but started having symptoms, including chills, fever and a dry cough, at the end of March.
By the time her parents took her to the hospital, her oxygen level was low.
“She was on the ventilator for two days and not improving,” said Karla’s mom, Ana Tejada. “They told me about the ECMO machine and said, ‘This is the last thing we can do for your daughter,’ I was crying and hysterical asking them to please save my child.”
Tejada was with her daughter day and night at the hospital, while her older daughter and husband stayed quarantined at home.
“I prayed, I played her music, I kept talking to her,” Tejada said. “The doctors and nurses were amazing. They checked on me, too, all the time.”
Karla remained on the ventilator while the ECMO machine acted as an artificial lung. It was connected to two large veins, removed her blood, clearing the carbon dioxide and adding oxygen, before returning it to her body.
Because her heart was strong, doctors were able to use the ECMO that takes over the function of her lungs while relying on her heart to function normally, Schneider said.
"It bought us some time to continue to allow her lungs to heal from the infection," he explained.
The risks, however, were still great. She needed to take blood thinners, so there was a chance she could have complications from bleeding, Schneider said.
And having Karla connected to a ventilator and an ECMO machine meant two nurses had to remain at her bedside 24 hours a day, at a time when hospital resources were stretched thin.
After seven days, she was removed from the ECMO, and about five days later she was able to breathe without the ventilator.
“That was the happiest day of my life,” Karla said.
Schneider said Karla's case also illustrates an important point about COVID-19 and children, who appear to be less impacted by the disease than adults.
“Definitely there's less symptomatic disease in kids compared to adults," he said. "However, children are not immune to this and can develop life-threatening illness."
Karla is continuing her recovery at home, taking medication and resting while her body continues to recuperate.
“Her lungs are still far from normal, and she will have physical limitations for a while,” Schneider said.
Karla’s success is a huge boost for Schneider and the rest of the hospital staff, considering they have seen many patients — despite their best efforts — never recover from COVID-19.
Schneider said some hospital staffers even came in on their day off just to celebrate her departure from the hospital. Karla said their constant support helped her through many scary days.
“They really uplifted my spirits,” Karla said. “They would come to the window [of the ICU room] and wave at me, give me thumbs-up and virtual hugs.”
She hopes the ECMO can be used to help other COVID-19 patients find a path to recovery.
“I’m happy to be the first young patient to use ECMO [at Cohen Children's Medical Center] and I want to show what this machine can do,” Karla said.
By Lisa L. Colangelo
lisa.colangelo@newsday.com @lisalcolangelo
Updated April 23, 2020
https://www.newsday.com/news/health/coronavirus/cohen-and-extracorporeal-membrane-oxygenation-1.44034780
Sixteen-year-old Karla Duarte was on a ventilator at Cohen Children’s Medical Center on April 4, battling COVID-19, the disease that was weakening her lungs. And she was getting worse.
Doctors already had tried conventional therapies and experimental drugs before deciding to take a much bolder step. They put Karla on an extracorporeal membrane oxygenation (ECMO) device that took over the function of her lungs and added extra oxygen to her blood.
While the ECMO has proved successful treating people with serious pneumonia as well as heart and lung problems, the hospital had not used it on a juvenile patient with COVID-19, the disease caused by the coronavirus SARS-CoV-2.
“She was failing,” said Dr. James Schneider, chief of pediatric critical care medicine at Cohen Children’s Medical Center. “She was a previously healthy young lady … it was worth trying.”
The device’s therapy, which has been in use for decades, reportedly has been used in other hospitals to treat adult patients with COVID-19. The U.S. Food and Drug Administration earlier this month cleared it for use on patients suffering extreme conditions from the virus.
Karla was discharged from the New Hyde Park hospital Sunday to rousing cheers from Schneider and the rest of the staff. They believe she is one of the first pediatric cases successfully treated with an ECMO machine.
“I was crying so much,” Karla said about her spirited send-off from the hospital. “I was so emotional, I couldn’t speak. They saved my life.”
The teen, who lives in Queens Village, isn’t sure how she contracted the coronavirus but started having symptoms, including chills, fever and a dry cough, at the end of March.
By the time her parents took her to the hospital, her oxygen level was low.
“She was on the ventilator for two days and not improving,” said Karla’s mom, Ana Tejada. “They told me about the ECMO machine and said, ‘This is the last thing we can do for your daughter,’ I was crying and hysterical asking them to please save my child.”
Tejada was with her daughter day and night at the hospital, while her older daughter and husband stayed quarantined at home.
“I prayed, I played her music, I kept talking to her,” Tejada said. “The doctors and nurses were amazing. They checked on me, too, all the time.”
Karla remained on the ventilator while the ECMO machine acted as an artificial lung. It was connected to two large veins, removed her blood, clearing the carbon dioxide and adding oxygen, before returning it to her body.
Because her heart was strong, doctors were able to use the ECMO that takes over the function of her lungs while relying on her heart to function normally, Schneider said.
"It bought us some time to continue to allow her lungs to heal from the infection," he explained.
The risks, however, were still great. She needed to take blood thinners, so there was a chance she could have complications from bleeding, Schneider said.
And having Karla connected to a ventilator and an ECMO machine meant two nurses had to remain at her bedside 24 hours a day, at a time when hospital resources were stretched thin.
After seven days, she was removed from the ECMO, and about five days later she was able to breathe without the ventilator.
“That was the happiest day of my life,” Karla said.
Schneider said Karla's case also illustrates an important point about COVID-19 and children, who appear to be less impacted by the disease than adults.
“Definitely there's less symptomatic disease in kids compared to adults," he said. "However, children are not immune to this and can develop life-threatening illness."
Karla is continuing her recovery at home, taking medication and resting while her body continues to recuperate.
“Her lungs are still far from normal, and she will have physical limitations for a while,” Schneider said.
Karla’s success is a huge boost for Schneider and the rest of the hospital staff, considering they have seen many patients — despite their best efforts — never recover from COVID-19.
Schneider said some hospital staffers even came in on their day off just to celebrate her departure from the hospital. Karla said their constant support helped her through many scary days.
“They really uplifted my spirits,” Karla said. “They would come to the window [of the ICU room] and wave at me, give me thumbs-up and virtual hugs.”
She hopes the ECMO can be used to help other COVID-19 patients find a path to recovery.
“I’m happy to be the first young patient to use ECMO [at Cohen Children's Medical Center] and I want to show what this machine can do,” Karla said.
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Girl, 16, was losing COVID-19 fight. Then a bold step helped - JeffB MU - 4/24 20:50:53