Hemodynamic stability and the eventual weaning off of all inotropes were made possible and the youngster was later extubated with full neurological function, however he initially suffered from severe neuromyopathy and symmetrical peripheral gangrene due to protracted shock. Despite being on mechanical ventilation and maximum circulatory support with triple inotropes - epinephrine, norepinephrine, and vasopressin - the child continued to deteriorate, placing the clinical team in an extremely challenging situation.
A carefully thought-out trial of methylene blue for refractory vasoplegic shock was started after traditional therapy failed. Hemodynamic stabilization and the gradual weaning off of all inotropes were made possible by this crucial intervention. The child initially experienced severe neuromyopathy and symmetrical peripheral gangrene as a result of prolonged shock, but he was later extubated with intact neurological function.
With sustained multidisciplinary care and rehabilitation, the child made a remarkable recovery. He was discharged safely and recently returned for follow-up with complete neurological recovery, restored muscle strength, and an inspiring smile. This remarkable result is a testament to the skill, tenacity, and commitment of our PICU team lead by Dr Ashutosh Sinha and Dr Puneet Yadav, who continue to provide life-saving care in the most dire circumstances.
