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This article celebrates the 2018 recipients of the Society of Critical Care Medicine’s ICU Heroes Award.
Merriam-Webster’s Collegiate Dictionary defines hero as “one who shows great courage.” So, what is courage? Courage is a 4-year-old boy surviving 99 days in the pediatric intensive care unit (ICU). Courage is a 66-year-old man defying the odds and low survival rate of a rare lung condition to return to a healthy lifestyle. Jake LaRose and Ralph Gervasio are the 2017 recipients of the Society of Critical Care Medicine’s ICU Heroes Award. The two were recognized, along with their care teams, in February at the 47th Critical Care Congress in San Antonio, Texas, USA. Here are their stories.
In 2014 Jake LaRose was a happy and healthy 4-year-old boy. And then one day he wasn’t. In March, he came down with a stomachache that continued to worsen. A strain of Escherichia coli 0157:H7 led to hemolytic uremic syndrome—a combination of hemolytic anemia and renal failure—that quickly led to acute renal failure. He later developed peritonitis and a bowel perforation that led to severe septic shock and acute hypoxemic respiratory failure.
The team at Weill Cornell Medical College in New York City rushed LaRose into emergency surgery and discovered that his entire abdomen was filled with stool. What was supposed to be a multi-hour surgery ended up taking less than 45 minutes because the anesthesiologist did not think LaRose could survive the procedure. “They could barely keep him alive on the operating table,” said Kim LaRose, Jake’s mother.
That was one of three times LaRose almost died. The physicians left his abdomen open after the procedure, covered with what was, in effect, surgical-grade plastic wrap. This was the first of what would be a four-stage surgical repair that, besides the open abdomen, required an ostomy and mucous fistula.