Venovenous Extracorporeal Membrane Oxygenation in a Gravid Patient with Acute Respiratory Distress Syndrome: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis)
Christopher Nnaoma, Ogechukwu Z. Chika-Nwosuh, Anthony Isedeh, Jose Bustillo, Abdullah Al Twal, Patrik Patel
(Department of Internal Medicine, Newark Beth Israel Medical Center, Newark, NJ, USA)
Am J Case Rep 2019; 20:705-708
Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is a technique used to provide prolonged cardiac and respiratory support to persons whose heart and lungs are unable to deliver adequate perfusion or gas exchange to sustain life.
It is indicated in patients with severe ARDS, severe hypothermia, and cardiac and respiratory failure when other conventional methods fail.
CASE REPORT: We report the case of a 22-year-old gravid 2 Para 1 woman who presented to the Emergency Department with pyelonephritis, who subsequently developed sepsis that progressed to ARDS. She was managed successfully with extracorporeal membrane oxygenation [ECMO] for 5 days, with heparin used as an anticoagulant. After significant improvement, she was successfully de-cannulated and extubated.
CONCLUSIONS: The use of ECMO in pregnancy and post-partum can be associated with several complications to both mother and fetus. With appropriate patient selection, good knowledge of the procedure, and early initiation, successful outcomes can be attained.
Keywords: Extracorporeal Membrane Oxygenation, Pregnancy Complications, Respiratory Distress Syndrome, Adult