Miracle baby Ignus beats rare condition
BORN with his organs compressing his lungs, Baby Ignus has survived against enormous odds in what is thought to be a first for South Africa.
Doctors believe his survival is an absolute miracle. “The overall chance of survival for Ignus, all things considered, was extremely low, if not non-existent. Not only has he survived, but all indications are that he is physically well and neurologically sound,” said Dr Ashley Jeevarathnum, a paediatric pulmonologist practising at Netcare Clinton Hospital in Alberton.
Baby Ignus is recovering at home after two months of tireless efforts and prayers from a highly skilled team of paediatric and neonatal specialists, nurses and the baby’s family.
Recalling the birth of Ignus, her second son, on April 15, before it was discovered that he had a life-threatening internal birth defect, Nadia Greyling said: “The first cry of your newborn baby is the most beautiful sound ever. My husband and I nodded at each other. We had no idea of what was waiting for us.
“Six weeks – 1 008 long hours since he was born – I could hold my baby for the first time. What an amazing feeling,” said Greyling.
The treating paediatrician in theatre had discovered almost immediately after Ignus was born that he was not breathing as he should.
He was rushed to the hospital’s neonatal intensive care unit) for observation, and the baby was intubated and put on a ventilator to support his breathing – the first of many “lifelines” that would help sustain him in the fight to save him over the coming weeks.
“The next morning, neonatologist Dr Klaas Mnisi explained to us that Ignus had something 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.
Ignus did not respond to the initial therapeutic measures as hoped. “The pressures in his lung were exceptionally high, a condition known as pulmonary hypertension, and all life and respiratory support measures had failed.
“For any chance of saving his life, the therapy had to be escalated to extracorporeal membrane oxygenation (Ecmo) life support.
“Ecmo is a highly specialised process where a machine artificially performs the functions of the heart and lungs, 24 hours a day for 12 days, in Ignus’s case,” said Jeevarathnum.
“Although Ecmo is well established in adult care in South Africa, and is a very good therapeutic strategy, it comes with huge risks for a neonate, or newborn baby.
“Ecmo for a neonate with CDH is internationally known to be notoriously difficult.
“However, it was the best option available to support his vital functions and get him well enough for surgery,” said Jeevarathnum.
Baby Ignus had a team of about 10 doctors. After almost two weeks of the therapy, the specialists agreed that Ignus was in a better condition for the surgery to repair the hole in his diaphragm that would keep his abdominal organs, including his intestines, liver and spleen, in their correct anatomical position to relieve the pressure on his lungs.
Paediatric surgeon Dr Carapinha, who was part of the team treating Ignus from the day he was born, performed the crucial operation to correct the life-threatening CDH.
“We had been quite concerned about Ignus in the first week or two, however, his condition stabilised on Ecmo sufficiently for the procedure to go ahead.”
“Ignus’s lungs and their blood vessels were under severe pressure due to his abdominal organs pushing through the large hole in his diaphragm.
“During the operation, a special patch of collagen was used to close the hole in his diaphragm, as this creates a biological seal that is as natural as possible for a growing baby.
“Throughout, Ignus’s parents were very much at the centre of the team. They were fully informed of the potential risks involved at each stage, transparently and objectively.
“To my knowledge, Ignus is the first baby born with CDH in South Africa, that has completed Ecmo and subsequently went on to have a successful diaphragmatic hernia repair. He has tolerated the procedure well, and his progress has been remarkable. Our ‘Little Soldier’ was ready to go home, at last,” said Carapinha.