Karla Duarte was admitted on March 29 after a week of fever, body aches, and breathing difficulties, according to Dr. James Schneider, chief of pediatric critical care medicine at Cohen Children's Medical Center.
He said she tested positive for the novel coronavirus and was started on supportive treatment, but three days later, she was transferred to the pediatric intensive care unit for worsening symptoms and higher oxygen needs.
"I even asked my mom, when is this going to be over?" she said. "And she said, 'Soon, mama, soon.'"
She was intubated and put on a ventilator the next day, but as her condition continued to worsen, doctors made the decision to use an invasive therapy called veno-venous extracorporeal membrane oxygenation, or VV ECMO.
During the procedure, blood is removed from the body, passed through an artificial lung to remove carbon dioxide and add oxygen, then returned to the body.
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"We did decide to use it on her, because it was either try it and use our expertise, or she was likely not going to survive," he said.
Dr. Schneider said the therapy requires significant resources and comes with risks, and additionally has with no proven benefit in children with COVID yet. But due to Karla's young age and previously healthy status, along with the team's previous success with its use in other children with severe lung infections, ECMO was offered and initiated.
"It was really scary," mom Ana Tejada said. "And I told the doctor, 'Do whatever you have to to save my daughter.'"
Despite various common challenges with ECMO, some unique to patients with COVID, Dr. Schneider said Karla was successfully removed from ECMO on April 10 and continued to improve.
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"Frankly, she's a 16-year-old tough kid, and we were relying on kids' resilience to improve," he said.
She was extubated on April 15 and released from the hospital on April 19.
"Eventually they said, 'I think she's ready,'" Tejada said. "And that was the most amazing moment when they took her off the ventilator, and I said, 'Wow, God has heard our prayers.'"
Dr. Schneider said that when she was discharged, Karla was breathing room air, eating normally, and ambulating.
"The entire place was full of tears," he said. "It was absolutely wonderful and made every moment of extra work worth it."
It is believed that this is the first such example of the therapy being used in a young person on a ventilator from COVID-19.
"I remember Dr. Schneider always told me, 'You are a miracle child,' and those words will forever stick with me," Duarte said. "They are my heroes, and they will forever be in my heart."
Dr. Schneider credited the entire Cohen Children's team, including pediatric ICU nurses and physicians, ECMO nurse specialists, perfusionists, and surgeons.