A severe infection damaged the boy’s lungs, but critical care doctors at Stanford Medicine and Children’s Medical Center took time to heal him.
Literally in one day, Jordy Gonzalez Perez’s life changed. He went from playing soccer and feeling healthy to having to fight for his life.
And it all started with a simple dry cough.
“On his last day of school in third grade, he came home with a cough and a rash on his face, chest, and back. We took him to a clinic near his home in Wenatchee, Washington, where he was diagnosed with allergies. He was sent home,” said his mother, Griselda Gonzalez.
However, it wasn’t an allergy. It was more complex and difficult to pinpoint.
The next day, Jordy developed a high fever and was having trouble breathing. His family rushed him to a local hospital, where doctors discovered his right lung had collapsed. The 9-year-old boy was then airlifted to a hospital in Spokane, Washington. He was in acute respiratory failure.
“I couldn’t believe it. My child has always been so energetic. It was really scary,” Griselda said.
In Spokane, Jordy received extracorporeal membrane oxygenation treatment (ECMO) is a sophisticated machine that draws blood from a patient, oxygenates it, and pumps it back into the patient’s body. Geordie’s lungs were replaced because they were too damaged to survive. ECMO is the highest level Emergency and emergency support For children (and adults) with heart and lung problems.
“He was really, really sick. We were told he probably wouldn’t survive. It was really hard to hear that,” Griselda says.
Although Geordie overcame the infection, doctors in Spokane diagnosed him with the following symptoms: pulmonary fibrosisThis means that his lungs were injured and damaged for unknown reasons. Geordi’s local doctors recommended that he undergo a lung transplant test, but the hospital did not offer it.They decided Geordie needed to go. Stanford Medicine Children’s Health.
The ECMO team picks up Geordie and takes him to Stanford Children’s Home.
Transferring children on ECMO from one hospital to another is rare and requires a complex and well-coordinated effort. Only a few such transfers occur each year at Stanford Children’s Hospital, and typically only large children’s hospitals offer ECMO.
“We only provide ECMO transport when the child requires the advanced services we provide. transplant evaluations, complex diagnostic work-ups, or long-term mechanical support.” Dr. Kathleen Ryandirector of the ECMO service at Stanford Medicine Children’s Health’s Betty Eileen Moore Pediatric Heart Center and a critical care physician specializing in cardiology.
ECMO transport often requires many travel distances and many patient transfers. It took three steps to transport Geordi: putting a transport team in an ambulance, taking him to the airport, flying to a local airport, and then riding in an ambulance to the hospital. The three-step process is then reversed, this time to the patient.
“As we move people who rely on mechanical circulatory support to survive, many maneuvers are required. During our journey through the hospital, we navigate elevators, ambulances, and steps to get on and off planes. “You hold all of the patient’s machines, plus the cannula and breathing tube, in place while going through the process. It’s very complex and requires a great deal of teamwork,” says Dr. Ryan.
Led by Dr. Ryan Critical care The team that picked up Geordi included Stanford pediatric emergency transport nurses; respiratory care Transport therapists, perfusionists, contract pilots and flight nurses.
Arrives at Stanford Children’s Hospital for lung transplant evaluation
Geordie’s lungs are severely damaged; lung transplant team probably to him lung transplant. There are seven pediatric lung transplant programs in the United States, and Stanford Medicine Children’s Health is the only one on the West Coast.
But before Jordy underwent such major surgery, the team wanted to keep him as healthy as possible. And if children receive enough support on her ECMO, they may eventually recover without the need for a lung transplant. Lung transplantation is a wonderful, life-saving procedure, but donated lungs are difficult to obtain and transplanted lungs do not last a lifetime.
“We found that if we properly support a child on ECMO over a long period of time, their lungs may eventually heal,” Dr. Ryan says.
Introducing innovative use of ECMO to help Geordie recover
When Jordy arrived at Stanford Children’s Hospital, he had an ECMO cannula (a tube that carries blood between his body and a machine) inserted into his neck. Although this is normal cannula placement, it was not ideal for Geordie. The tubes made it difficult for him to move and he was basically stuck in bed. Plus, I needed sedation to deal with the cannula, which took away my energy.
“We knew we needed to get Geordie up and moving to improve his lung condition. When a patient breathes on their own, it’s often good for the lungs,” Dr. Ryan said. say.
When patients receive ECMO at Stanford Children’s Hospital, they receive care from a multidisciplinary team of physicians who implement their rehabilitation plan.Geordie’s team also participates critical care doctor, heart surgeon, lung transplant Physicians, perfusionists, ECMO specialists, respiratory therapists, physically and occupational therapist.
“Our ECMO rehabilitation program is amazing, and we couldn’t do it without everyone involved,” adds Dr. Ryan.
When an ECMO cannula is placed in the neck to support the lungs, blood is drained from the superior and inferior vena cava and returned to the right atrium of the heart. However, this setup did not help Geordie heal, so the ECMO team decided to try a new ECMO cannulation strategy for her.
“We inserted both cannulas directly into his heart. It supported his lungs better and allowed him to get up and move,” says Dr. Ryan.
The end of the cannula that was connected to the ECMO machine was moved from Geordie’s neck to his abdomen, allowing him more freedom of movement. He was able to sit up in bed and start moving with the help of an occupational therapist and physical therapist.
Wake up Geordi and help his lungs heal.
“It was amazing to see how Geordi changed throughout the process,” says Ozzie Jahadi, manager of perfusion and ECMO services at Stanford Children’s Hospital. “At first, just getting from the bed to the footstool hurt. We slowly worked together to get his muscles working again. Eventually, the nurses who were on break and stopped by for a visit… It was so nice to see him walking down the halls and playing cards.”
As Geordie came off sedation and had more daily movement, his quick-witted and playful personality returned. His parents took turns caring for him and his siblings at their home in Washington. The family video chatted to stay in touch.
“At one point, Jordy got really unwell and said to me, ‘I don’t want to die.’ So to see him walking around with his machine and doing his best to get better was very I was so proud,” Griselda says.
A pleasant surprise after months of recovery
Jordy spent 10 months recovering and regaining his strength at Stanford Children’s Center.She celebrated her 10th birthday while in the hospital.th Birthday, Halloween, Thanksgiving, Christmas. On his birthday, the nurses decorated his hospital room at night so he would wake up to a bright scene.
“We provide care that goes beyond medicine. It’s care of hope,” Jahadi says. “It was truly amazing to see the joy we brought to him, his family and staff on his birthday.”
Another nurse made Geordie a Robin costume for Halloween and had him wear it trick-or-treating in the hallway. At Thanksgiving, one of the doctors brought a special dish to share with his family, and his care team gave him a Christmas present.
“Jordie remembers those days well. [Packard Children’s] hospital. “He doesn’t remember the hard things, but he remembers the nurses and doctors and the good memories he had with them,” Griselda says.
Dr. Ryan and colleagues at Stanford Children’s Center Dr. Carol Conradand Vamsi Yarlagadda, Marylandpublished an article about Geordie and them. Innovative ECMO cannulation strategy inside Journal of Thoracic Cardiovascular Surgery.
“Our unique approach to Geordi’s ECMO cannulation ultimately accelerated his recovery,” says Dr. Ryan. “I couldn’t be more proud of our ECMO team for him. It was a huge accomplishment and he did great.”
After Jordy spent 158 days on ECMO, his family received great news. He no longer needed a lung transplant.
continue to live life as a normal teenager
Geordie is now 15 years old and his hospital stay is in the rearview mirror. He enjoys all the things teenagers like, like playing with friends and going to school.
“Jordi is a very happy child,” Griselda says.
He loves kicking the soccer ball with his cousins, but he can’t play on a team. I no longer need regular supplemental oxygen, but I don’t have the lung capacity to play team sports. But instead of soccer, he does other activities that he loves, such as riding dirt bikes, going camping, and reading books.
Families have remained connected to Stanford Child Care team members over the years because many of them feel like family.
“I highly recommend Stanford Medicine Children’s Health. The nurses and doctors are really great and kind,” says Griselda. “I’m so happy to be with Geordie today.”
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