Medical Team from Shanghai General Hospital Work Around the Clock and the Multi-disciplinary Cooperation Turn the Corner

Source: Xinmin Evening News Author: Gao Yang correspondent: Su Qi Hu Yang 16:26:00, February 26, 2020

Picture Description: the medical team of Shanghai General hospital successfully treated a 70-year old male patient with CRRT blood purification technology in Leishenshan hospital. Picture source: Leishenshan Hospital(the same below)

    Recently, Shanghai General Hospital medical team in Leishenshan hospital has successfully treated a novel coronavirus pneumonia patient with hyperkalemia and chronic renal failure by using CRRT (continuous renal replacement therapy) blood purification technology. This is also the first time that the new batch of Shanghai General Hospital medical team apply CRRT to treat novel coronavirus pneumonia patient, after the team took over the first ward of third infection department.

    A 70-year old male patient suddenly developed symptoms of chest tightness, shortness of breath, and rapid decrease in peripheral blood oxygen saturation. The blood potassium for emergency examination was as high as 8.0mmo/L. The patient has a history of chronic renal insufficiency and needs long-term hemodialysis. The current examination results indicate that the internal environment of the patient has been seriously disturbed, and there may be malignant arrhythmia or cardiac arrest at any time. 

    “CRRT blood purification treatment must be carried out right now!” The doctor on duty in the ward make a decision and report to the medical team leader, nursing team leader and medical team leader immediately, and prepare to start CRRT treatment according to the predetermined plan. 

 CRRT blood purification can be used to correct the acid-base imbalance and electrolyte disturbance in patients, and to remove inflammatory factors and reduce lung water. CRRT is one of the effective and supportive treatment for patients with the novel coronavirus pneumonia. However, the patient’s condition is critical and complex, and the CRRT treatment needs the multidisciplinary cooperation.

At this time, the integrated team organized by Shanghai General Hospital featuring multi-discilinary cooperation shows great advantage. Experts from respiratory department, emergency critical care department, cardiology department, nephrology department and other departments were in place as soon as possible. According to the patient’s state and existing conditions, a treatment plan was formulated. Jiang Tingting and Zha Yixin, nurses of hemodialysis room, completed the operation of startup, installation, pre-filling pipeline, operation and parameter adjustment at the fastest speed.

CRRT itself is a very mature diagnostic technology. However, in the first ward of the third infection department of Leishenshan Hospital, medical staff wear heavy protective clothing, have limited vision, and wear several layers of gloves. The difficulty of performing deep vein catheterization, CRRT loading and treatment is greatly increased. They have to stand very closely to the patients to perform the operation which may expose them to great risk.

With rich experience and excellent technology, the blood purification team of Shanghai General Hospital successfully loaded the device. After 8 hours of CRRT treatment, the patient’s blood potassium decreased significantly. His acidosis was corrected with vital signs stable. Finally, the patient was turned to safety.