Rainbow Children’s Hospital Saves Three-Year-Old in Extremely Rare Critical Care Scenario

In India, the prevalence of tuberous sclerosis complex is about 1 in a lakh individual, and PARDS affects approximately 6% of all patients requiring mechanical ventilation in Paediatric Intensive Care Unit (PICU). It is also important to highlight that in severe cases of PARDS, the case mortality rate is 32% which is significant in highlighting the importance of survival in this specific case.

The 3 year-old boy came to the hospital earlier this year and presented with fever, tachypnea, and profound dyspnea. Due to the acute type 1 respiratory failure, he was put on mechanical ventilation due to PARDS. His condition was further complicated by difficult-to-control seizures requiring high doses of repeated anti-epileptic drugs. Without urgent and aggressive intervention, the risk to life was extremely high.

The child received continuous intensive care and invasive mechanical ventilation in the PICU. Although he was extubated after seven days, he experienced significant respiratory and neurological regression which necessitated re-intubation four times over the course of six weeks. He also suffered multiple spontaneous and tension pneumothoraxes - two of which caused peri-cardiac arrest - and recurrent infections including mycoplasma, enterovirus, and adenovirus. ECMO was considered but not performed due to his neurological status and parental decision; instead, he was managed with high-frequency oscillatory ventilation.

“This was one of the most challenging cases we have encountered in our PICU,” said Dr. Anupam Jaiswal, PICU Lead Consultant, Rainbow Children’s Hospital, Bannerghatta. “The child faced multiple, simultaneous life-threatening complications, and every decision had to be swift, precise, and personalised.”

Dr. Prakash Vemgal, Director of Pediatrics, Rainbow Children’s Hospital, Bannerghatta added; “The rarity and severity of his condition meant there was no room for error. His survival and recovery reflect the importance of integrated paediatric critical care, sustained multidisciplinary teamwork, and the trust and cooperation of his family.”

In spite of extreme complications like pneumonia, septic shock, and polyneuropathy, the multidisciplinary team - consisting of paediatric intensivists, neurologists, pulmonologists, and ENT specialists - coordinated with the family in close association to sail through every crisis. 

The child was discharged couple of months back and has, since then needed 3 additional hospital admissions over time for ongoing care and device problems for tracheostomy closure. Following the acute crisis, he is on less seizure medications, controlled seizures, breathing and speaking normally, eating and is able to walk independently in the absence of home ventilation.

The family went through significant emotional burdens and yet chose to work with the medical team which greatly contributed to this child’s change in health. Today he is able to live and enjoy an active and social life like his peers which is a remarkable change from the repeated critical health episodes he was facing.

About Rainbow Children’s Hospital

Rainbow Children’s Medicare Limited network comprises of 21 hospitals and 5 clinics in 8 cities, with a total bed capacity of 2,035 beds. Our Paediatric services operating under the brand “Rainbow Children’s Hospital” includes new born and Paediatric intensive care, Paediatric multi-specialty services, Paediatric quaternary care (including organ transplantation); whereas our women care services under “Birthright by Rainbow” offers perinatal care services which includes normal and complex obstetric care, multi-disciplinary fetal care, perinatal genetic and fertility care along with gynaecology services.

Rainbow Children’s Hospital built on strong fundamentals of a multidisciplinary approach with a full-time consultant led clinical service along with 24/7 commitment in a child centric environment. The company follows a hub-and-spoke operating model where the hub hospital provides comprehensive outpatient, inpatient care, with a focus on tertiary and quaternary services, while the spokes provide 24/7 emergency care, large outpatient services and comprehensive obstetrics, Paediatric inpatient and level 3 NICU services. This model is successfully operational at Hyderabad and is gaining traction in Bengaluru. The endeavour is to replicate this approach in Chennai and across the National Capital Region. Subsequently Rainbow intends to expand into tier-2 cities of Southern India.

Rainbow Children’s Hospital embraces a unique doctor engagement model, where doctors work exclusively on a full-time, retainer basis. The doctors work in teams and have 24/7 commitment, which is particularly important for children’s emergency, neonatal, Paediatric intensive care services and to support Paediatric retrieval services. The Company also operates the country’s largest Paediatric DNB training program in private healthcare, offering post graduate residential DNB and fellowship program. For more information, log on to: https://www.rainbowhospitals.in/