THE DARKEST HOUR COMES JUST BEFORE DAWN
A 28 days old male baby had been admitted in the NICU of Ruby General Hospital under the expert care of Dr. Anirban Basu (Consultant Paediatrician) with complaints of severe respiratory distress and recurrent apnea along with severe respiratory and metabolic acidosis. The baby later developed features of myocarditis (Inflammation of the heart muscle i.e. myocardium). After thorough evaluation and relevant investigations the chest X-ray revealed right upper and middle zone consolidation. The baby was immediately intubated and put on ventilation with Synchronized Intermittent Mandatory Ventilation (SIMV) and he remained on invasive ventilation for four days followed by nasal CPAP (Continuous Positive Airway Pressure) for next four days. The blood reports revealed procalcitonin of 22.7, D-Dimer of 12500 and NT-proBNP more than 35000. During the course of treatment, the baby developed a heart rate of more than 220 and blood pressure started falling by day three needing Dopamine, Noradrenaline and Adrenaline infusion, later followed by Milrinone infusion for 72 hours. Following extubation, initially the baby was doing well but, he developed tachypnea (rapid breathing) and chest X –ray revealed right upper lobe collapse which was resolved with positive pressure ventilation, positioning and chest physiotherapy, followed by left lower zone collapse which was resolved in two days. Opinion of Pulmonologist had been taken and duly followed. Gradually, the baby improved and was taking feeds orally. The parents whose hopes were almost sinking thanked the hospital and the entire Paediatric team with a grateful heart as they carried their bundle of joy home.