A 43-year-old male, who thought to be at Death's Door in a life-threatening acute pulmonary edema complicated with a severer end-stage renal disease, was successfully treated with vascular interventional surgery and dialysis treatment after admission at City International Hospital.

   A 43-year-old male T.Q.C, who was seen by his primary care physician (PCP) roughly 5 days prior to arrival to our Emergency Department (ED) on 12 April 2019 for symptoms consistent with sudden onset shortness of breath at night while sleeping with an 5-day history of fever, myalgia, back pain, nausea and vomiting, visual impairment, anuria and weight gain of 15 kg within 1 week. On examination, patient T.Q.C was found to be dyspneic, drowsy, pale, diaphoretic, and restless. His critically fluid overload is related to increased mortality and also lead to several complications like pulmonary edema, cardiac failure, delayed wound healing, tissue breakdown, and impaired bowel function. Furthermorre, he has a history of hypertension, obesity, type 2 diabetes and was later confirmed to have an acute pulmonary edema in an end-stage renal disease.

   Under City Plus Program, a Unique Multidisciplinary team of doctors working together from various specialties (Critical Care and Resuscitation, Artificial Kidney, Cardiology and Endocrinology), nurses, and other specialists, therefore conducted an analysis to provide an extra layer of support and deliver appropriate care at any stage in a serious illness and can be provided together with curative treatment. The patient with past history of hypertension, obesity, type 2 diabetes, after a series of clinically lab testing and radiology investigations later confirmed to have a serious urinary infection, severe anemia, and was later confirmed to have an acute pulmonary edema in an end-stage renal disease. 

Arteriovenous (AV) fistula surgery must be performed by a team of skilled surgeons.

  Two weeks into dialysis treatment and a very intensive pattern of medical care at CIH, the patient's vital signs and urinary tract infection (UTI) stabilized prior to hemodialysis and he was able to breathe smoothly. However his kidney function does not improve after addressing reversible causes of advanced renal failure. Severe acute kidney injury (AKI) requiring hemodialysis (HD) as initial manifestation is exceptional. With the increasing incidence of end-stage renal disease, hemodialysis vascular access presents an ongoing struggle, City Plus’ multidisciplinary approach must be considered to provide long-term durable access for a patient on chronic hemodialysis because it no longer responds to medical treatment, blood transfusion during hemodialysis, antibiotic treatment for experienced urinary infections, blood control Pressure and blood sugar combined with high doses of loop diuretics. The surgical team determined that patients need a long-term regular dialysis treatment.  

   The dialysis treatment continued and blood pressure treatment. On 27 April 2019, the surgeons performed a vessel mapping test Using Doppler ultrasound to evaluate blood vessels, how much and how quickly blood flows through arteries and veins. After studies of vascular disorders of the upper extremity, vascular surgeons and anesthesiologists at City International Hospital performed arteriovenous (AV) fistula surgery and a venous surgery catheter which worked perfectly and still is functioning well.

  • Fistula is a connection, made by a vascular surgeon, of an artery to a vein to provide good blood flow for dialysis for long-term. A venous catheter is a tube inserted into a vein in the neck, chest, or leg near the groin, only for short-term hemodialysis.
  • An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels and less likely to get infected or cause blood clots than other types of access. Without this kind of access, regular hemodialysis sessions would not be possible. Untreated veins cannot withstand repeated needle insertions. They would collapse the way a straw collapses under strong suction.

Patient T.Q.C on the day of discharge

  The patient was discharged 3 weeks after. The patient told us that he had good diuresis and his blood pressure was stable and well controlled. He still periodically comes back for dialysis. The vital role of vascular access in the comprehensive care of hemodialysis patients cannot be overemphasized. Care of the hemodialysis patient includes management of uremia, hypertension, sodium and water balance, anemia, mineral metabolism, metabolic...

  On the day of discharge, Ms. H. patient's wife told us:” C. was getting ready for the trip to Singapore he was found to be dyspneic, drowsy, pale, diaphoretic, and restless. We immediately took him to the local hospital for emergency. Four days after admission with no improvement, we asked for a referral to  City International Hospital as we  heard of its new  City Plus Program and patients are offered a multidisciplinary approach to care . One month into City Plus, we have seen significant improvement, rapid recovery thanks to City International Hospital.

City International Hospital’s City Plus Program 

(scheduled to launch at the end of June 2019) is a professional medical program which was started by the enthusiasm of Dr. Dao Thi My Van – CIH’s dynamic and enthusiastic Deputy Medical Director & Head of Intensive Care Unit.

  • City Plus’s world-class Medical Second Opinion Program brings you Closest To The Cure. When you or your loved ones are diagnosed with a serious medical condition, you want the best medical advice from the country’s best hospital and top physicians. City Plus offers better quality of expert diagnosis help patients feel comfortable compared to the initial diagnosis. We utilize a collaborative and holistic medical review by our multidisciplinary team of expert physicians from all over the country, not just a single physician review; City Plus provides medical information and recommendations from expert physicians who practice at City International Hospital (CIH).
  • A Unique Multidisciplinary approach could save your life. City Plus’s premiere service offering, a remote medical second opinion (MSO) service provides our users the option of having their diagnosis and/or treatment plan evaluated by some of the top medical minds in the region, allowing them access to the most up to date clinical information available on almost any medical condition. Our Unique Multidisciplinary team of doctors working together from various specialties (Critical Care and Resuscitation, Artificial Kidney, Cardiology and Endocrinology,...), nurses, and other specialists, therefore conducted an analysis to provide an extra layer of support and deliver appropriate care at any stage in a serious illness and can be provided together with curative treatment.
  • CIH’s City Plus brings answers and peace of mind to them. All it takes is a phone call to get started. (+84) 28 6280 3333 (Press 0 and talk to the operator.)

"CIH-BBraun" Hemodialysis Center

Opened its door in 2013, provides a highly qualified and experienced medical team of specialists backed by modern medical equipment capable of taking exceptional care of patients suffering from acute and chronic kidney diseases. The center offers quality service for patients with acute as well as chronic kidney failure and also end-stage renal disease. The Center provides comfortable and safe environment for dialysis. With the help of the latest dialysis and life-saving technologies, the kidney specialist and certified nurses at the center closely supervise the dialysis procedures to ensure professional services with optimal outcome.

City International Hospital

  • Add: No. 3, 17A Street, Binh Tri Dong B Ward, Binh Tan Dist. (Next to AEON Mall Binh Tan), HCM City.

  • Tel: (+84) 286 280 3333 (Press 0 and talk to the operator.)

  • Site: https://cih.com.vn/en/

  • Email: This email address is being protected from spambots. You need JavaScript enabled to view it.