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Turk J Emerg Med. 2019 May 15;19(3):111-112. doi: 10.1016/j.tjem.2019.04.003. eCollection 2019 Jul.
Successful use of VV-ECMO in a pregnant patient with severe ARDS.
Carlier L1,2, Muller J3, Debaveye Y3,4, Verelst S2,5, Rex S1,6.
Author information
Abstract
Introduction:
Around 0.1-0.2% of all pregnancies are complicated by respiratory failure. The altered physiology of pregnancy predisposes mother and child to develop hypoxia and respiratory failure more easily than a non-pregnant patient. Respiratory failure in pregnancy may have detrimental fetal complications, therefore extensive knowledge of the range of therapeutic options is necessary. If conventional lung-protective mechanical ventilation strategies fail, alternative approaches such as veno-venous extracorporeal membrane oxygenation (VV-ECMO) should be considered.
Case presentation:
A previously healthy 30-year-old P1G2 at 26 weeks and 6 days of gestation was admitted to the emergency department because of a severe respiratory infection. She suffered of severe hypoxic respiratory failure due to an overwhelming pneumonia (influenza type A) with acute respiratory distress syndrome (ARDS). Because long protective ventilation strategies and ventilation in prone positioning were inadequate, and further respiratory deterioration occurred, VV-ECMO was initiated.
Conclusion:
In a pregnant patient with severe respiratory failure, when other interventions fail, initiation of VV-ECMO should not be delayed. The use of VV-ECMO in pregnancy is a multi-disciplinary team approach.
KEYWORDS:
Pregnancy; Prone ventilation; Respiratory failure; Veno-venous extracorporeal membrane oxygenation
PMID: 31321344 PMCID: PMC6612621 DOI: 10.1016/j.tjem.2019.04.003
Free PMC Article
Successful use of VV-ECMO in a pregnant patient with severe ARDS.
Carlier L1,2, Muller J3, Debaveye Y3,4, Verelst S2,5, Rex S1,6.
Author information
Abstract
Introduction:
Around 0.1-0.2% of all pregnancies are complicated by respiratory failure. The altered physiology of pregnancy predisposes mother and child to develop hypoxia and respiratory failure more easily than a non-pregnant patient. Respiratory failure in pregnancy may have detrimental fetal complications, therefore extensive knowledge of the range of therapeutic options is necessary. If conventional lung-protective mechanical ventilation strategies fail, alternative approaches such as veno-venous extracorporeal membrane oxygenation (VV-ECMO) should be considered.
Case presentation:
A previously healthy 30-year-old P1G2 at 26 weeks and 6 days of gestation was admitted to the emergency department because of a severe respiratory infection. She suffered of severe hypoxic respiratory failure due to an overwhelming pneumonia (influenza type A) with acute respiratory distress syndrome (ARDS). Because long protective ventilation strategies and ventilation in prone positioning were inadequate, and further respiratory deterioration occurred, VV-ECMO was initiated.
Conclusion:
In a pregnant patient with severe respiratory failure, when other interventions fail, initiation of VV-ECMO should not be delayed. The use of VV-ECMO in pregnancy is a multi-disciplinary team approach.
KEYWORDS:
Pregnancy; Prone ventilation; Respiratory failure; Veno-venous extracorporeal membrane oxygenation
PMID: 31321344 PMCID: PMC6612621 DOI: 10.1016/j.tjem.2019.04.003
Free PMC Article