In a first for Gauteng, if not in South Africa, a baby born with his organs compressing his lungs survived against all odds and finally returned home after two months of tireless efforts and prayers from a team of highly trained specialists. and the loving family of Baby Ignus.
“Your newborn baby’s first cry is the most beautiful sound ever. My husband and I bowed our heads. We had no idea what to expect,” said Nadia Greyling, recalling the birth of his second son, Ignus, on April 15, before it was discovered that he suffered from a life-threatening internal birth defect.
“Ignus’ overall chances of survival, all things considered, were extremely low to nonexistent. Not only did he survive, but everything indicates that he is in good physical and neurological health. It is an absolute miracle,” he said. said Dr Ashley Jeevarathnum, pediatric pulmonologist at Netcare Clinton Hospital in Alberton.
Almost immediately after Ignus was born, the pediatrician attending the theater found that Ignus was not breathing as he should.
He was rushed to the hospital’s neonatal intensive care unit (NICU) for observation, and the tiny baby was intubated and put on a ventilator to support his breathing – the first of many ‘lifelines’ who would help him fight to save him. over the next few weeks.
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“Someone tore the whole world from me under my feet”
“The next morning, neonatologist Dr Klaas Mnisi explained to us that Ignus had what is called a congenital diaphragmatic hernia. [CDH].
“Inside my baby’s body there was a large hole in the muscle that separates the chest from the abdomen, allowing his abdominal organs to push through the muscle and compress his lungs,” said Greyling. .
Dr Jeevarathnum says Ignus did not respond to initial therapeutic measures as hoped.
“The pressures in his lungs were unusually high, a condition known as pulmonary hypertension, and all life-support and respiratory support measures had failed.
“To have any chance of saving his life, therapy had to switch to extracorporeal membrane oxygenation [ECMO] life support. ECMO is a highly specialized process where a machine artificially performs the functions of the heart and lungs, 24 hours a day for 12 days, in the case of Ignus, ”explained Dr Jeevarathnum.
“Dr Ashley [Jeevarathnum] called us with the Ignus team of specialists and explained that our baby was not doing well at all, ”said Greyling. “It was as if someone had pulled the whole world under my feet, but we were desperate to give Ignus a chance.”
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“I counted eight or nine lifebuoys attached to his little body”
Although ECMO is well established in adult care in South Africa, it carries enormous risks for a newborn baby with CDH and is internationally known to be notoriously difficult.
However, Dr Jeevarathnum was convinced that this was the best option available to support baby Ignus’ vital functions and restore him sufficiently for surgery.
Little baby Ignus had a team of around 10 medics who all worked tirelessly to save his life.
NICU nurse Sr Zinhle Moyo remembers Ignus’ immense worry: “After he was born, the little baby was blue because he was not getting enough oxygen. We were so worried about him. When the decision was made to try ECMO, two children ICU nurses who have experience breastfeeding children on ECMO came to help us care for Ignus at the NICU. ”
Sr. Ngobese, affectionately known as “Gogo Khanyi” with some 36 years of nursing experience both in South Africa and abroad, says Ignus Nursing required everyone to “think 10 steps. in advance “.
“When you start a career in nursing, you make a promise to God that you will do anything to save a patient’s life. Even when I was at home I had to know how he was doing and I made the NICU promise to call me if there was any change in his condition or if there was any advice they had. need, ”said Sr. Ngobese, who worked nights to watch Ignus.
Ignus’ mother recalls that anxious time, vividly revealing: “At one point I counted eight or nine lifelines connected to his tiny body, drops, the ECMO machine itself, the hemodialysis, ventilator with nitric oxide and oscillator. “
Nadia Greyling holding her newborn son, Ignus.
After almost two weeks on ECMO, specialists agreed Ignus was in better shape for surgery to repair the hole in his diaphragm that would keep his abdominal organs, including his bowels, liver, and spleen, in their anatomical position. correct to relieve the pressure on his lungs.
Pediatric surgeon Dr Carapinha, who was part of the team treating Ignus from the day he was born, performed the crucial operation to correct the potentially fatal CDH.
“Ignus’ lungs and their blood vessels were under great pressure due to the pushing of his abdominal organs through the large hole in his diaphragm. During the operation, a special collagen patch was used to close the hole in its diaphragm, as this creates a biological seal effect that is as natural as possible for a growing baby.
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‘1,008 long hours …’
“Throughout Ignus’ parents were the center of the team. They were fully informed of the potential risks involved at each step, in a transparent and objective manner. To my knowledge, Ignus is the first baby born with CDH in South Africa who has completed ECMO and then successfully underwent diaphragmatic hernia repair. He tolerated the procedure well and his progress was remarkable. Our ‘little soldier’ was finally ready to go home, ”said Dr Carapinha.
“Six weeks – 1,008 long hours since birth – I was able to hold my baby for the first time. What an incredible feeling,” Greyling recalls.
Dr Jeevarathnum added that Ignus’ story “raised the bar for South African newborn care”, showing that international standards of medical care are achievable.
“Ignus’ excellent recovery proved what is possible.” Dr Jeevarathnum concluded.
“Probably the greatest gift one can receive is the gift of life.” Greyling added. “At one point, I thanked Dr Ashley for what he has done so far, and said he had performed a miracle. His words will stay with me for a long time and made me go through days and nights of uncertainty: “Christ did the miracle, he just used my hands’.”
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