Holistic Care for a Pediatric Patient with Kawasaki Disease Shock Syndrome Unresponsive to Intravenous Immunoglobulin: A Case Report
Zhang Jing
Children’s Hospital, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China.
Chen Jing
Children’s Hospital, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China.
Zhang Xipin
*
Children’s Hospital, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China.
*Author to whom correspondence should be addressed.
Abstract
This case report presents the application and outcomes of a systematic holistic nursing model for a pediatric patient with Kawasaki disease shock syndrome (KDSS) unresponsive to intravenous immunoglobulin (IVIG). In contrast to conventional task-oriented nursing, the holistic approach integrated advanced pathophysiology-based monitoring, proactive multi-organ support, individualized symptom management, and structured transition to home care. A 2-year-old girl with IVIG-unresponsive KDSS received two courses of IVIG (total 4 g/kg) plus glucocorticoids, alongside comprehensive holistic nursing interventions. Key outcomes included resolution of fever and shock, significant improvement in inflammatory markers (CRP, IL-6) and cardiac function (NT-proBNP), and discharge in stable condition after 12 days. Long-term follow-up confirmed a favorable cardiac prognosis. This case demonstrates that holistic nursing provides significant added value through its systematic, proactive, and continuous care framework, which is particularly crucial for managing complex, critically ill pediatric patients.
Keywords: Kawasaki disease, Kawasaki disease shock syndrome, IVIG-unresponsive, holistic nursing, pediatric nursing, post-discharge follow-up