Patient with progressive hypoxemia throughout the day despite multiple changes in ventilator settings/modes. HFOV discussed with family, but functional oscillator not available and was awaiting arrival of donor oscillator. She is not a candidate for ECMO due to pulmonary hemorrhage and thrombocytopenia with recent chemotherapy as well as BMI (morbidly obese). Trial on nitric oxide performed with minimal improvement (sats increased from 60% to 65-68%). She was noted to have increasing peaked T waves as well as development of Q waves concerning for hyperkalemia and worsening cardiac function consistent with multiorgan failure; perfusion was quite poor with mottled extremities and difficult to palpate central pulse
VAX DATE: 08 November 2021 |ONSET DATE: 10 November 2021 |DAYS TO ONSET: 2
COVID19 (COVID19 (PFIZER-BIONTECH))
11 November 2021
Pt expired 11/11/21 (Continued) despite vasopressor support. She was given a dose of bicarbonate with some brief improvement in saturations to 70s and increased heart rate but subsequently became asystolic and CPR was started. She was given epi x 2 doses as well as a dose of bicarbonate and was hand ventilated; there was significant blood backing up into her ETT. Parents at the bedside requested cessation of resuscitation efforts at that point and the patient was pronounced dead at 2036 on 11/11/21. The doctor of the heme/onc service made aware of the patient's death; she had been at the bedside earlier in the day and involved with the conversations regarding the patient's decline.