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Baby’s life was at risk due to a serious chest infection but expert care and extracorporeal membrane oxygenation helped him recover.
Nkateko Rivisi has made a strong recovery from a life-threatening respiratory infection. Picture: Supplied.
When a two-month-old baby’s chest infection suddenly turned serious, he was not breathing properly and was slipping in and out of consciousness, says his mother, remembering the horrifying realisation.
“I knew we had to try to keep him awake. He needed urgent medical care and so I drove with Nkateko on my lap to the emergency department at Netcare Waterfall City Hospital.
“I don’t remember parking the car – I just rushed him inside and they immediately put him on oxygen,” said Nthabiseng Mlangeni.
Baby’s chest infection suddenly turned serious
Nkateko was first admitted to the paediatric unit and his mother was able to remain with her son, rooming with him.
After several days in the hospital, Nkateko was again struggling to breathe, despite medication and physiotherapy to help clear mucus from his lungs.
Doctors transferred Nkateko, whose name means “blessing”, to the paediatric intensive care unit (PICU) under the care of paediatric intensivist Dr Palesa Monyake.
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“In the PICU, they started him on high-flow oxygen and Dr Monyake explained the unfamiliar environment to us, the treatment Nkateko was receiving and how they were monitoring his condition every minute.
“It was the hardest thing to leave my two-month-old baby and go home because parents can’t room with their children in the high-care environment,” Mlangeni said.
“I did not sleep at all that night, between worrying about Nkateko and anxiously expecting a call from the hospital at any moment. It was one of many sleepless nights in the weeks ahead, but we came to trust the PICU team implicitly.”
Swell up in response to infection
The next day, Nkateko’s vital statistics suddenly dropped further, requiring the baby to be placed on a ventilator, then on an oscillator to support his breathing.
“He started to swell up in response to the infection and it was extremely frightening to see all these tubes sticking out of him.
“Our families in Gauteng and other relatives travelled from different provinces to support us. We knew it was a very serious situation, and we prayed constantly,” Mlangeni said.
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Monyake said Nkateko was one of several children admitted to the PICU requiring critical care for respiratory syncytial virus (RSV) so far this year.
“Babies’ immune systems have not had the time to build up resistance to the many common germs such as RSV that generally would not cause serious illness among older children or adults,” she said.
“It is rare to put a child on extracorporeal membrane oxygenation, however, this RSV season has been particularly brutal, and we are grateful this lifesaving option is available for our patients who are in the critical situation that Nkateko faced.”
Life-threatening circumstances
Cardiothoracic surgeon Dr Sharmel Bhika said extracorporeal membrane oxygenation is a form of life support in which specialised equipment artificially performs the functions of the heart and lungs, giving them a chance to heal. It is only considered in life-threatening circumstances for such young children.
“Extracorporeal membrane oxygenation is a valuable lifeline when other forms of ventilation are no longer proving effective. Without this intervention Nkateko may not be with us today.
“He required maximum mechanical ventilatory support and was not reaching targets for adequate oxygenation.
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“Extracorporeal membrane oxygenation was a clear indication in Nkateko’s case with his rapid deterioration and increased demand on mechanical ventilatory support,” Bhika said.
Mlangeni said: “Although I felt like I was at breaking point, we remained prayerful. We also found comfort and support from the nurses and the unit manager Sister Jabulile Nxumalo.
“Every nurse who looked after Nkateko did so with so much care and they really supported us. The doctors, especially Dr Monyake, who was so supportive and prayed with us, and the extracorporeal membrane oxygenation doctors who ensured that we were updated throughout the process, and the families of other children who were also being cared for in the PICU.”
Every nurse who looked after Nkateko did so with care
The baby boy showed remarkable resilience as he fought for survival.
“Nkateko gradually improved enough that we could consider transitioning after three weeks back onto conventional ventilation,” Bhika said.
Monyake added: “This little boy had us so worried, it was an emotional roller-coaster, but his parents were amazing. They remained positive and drew strength from their faith.”
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