Successful use of VV-ECMO in a pregnant patient with severe ARDS
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 co...
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Wolters Kluwer Medknow Publications
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doaj-346eba52ead7425485c926c97e4916ea2021-04-02T12:43:02ZengWolters Kluwer Medknow PublicationsTurkish Journal of Emergency Medicine2452-24732019-07-01193111112Successful use of VV-ECMO in a pregnant patient with severe ARDSLaurence Carlier0Jan Muller1Yves Debaveye2Sandra Verelst3Steffen Rex4Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Emergency Medicine, University Hospitals Leuven, Leuven, Belgium; Corresponding author. Department of Anesthesiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.Department of Intensive Care, University Hospitals Leuven, Leuven, BelgiumDepartment of Intensive Care, University Hospitals Leuven, Leuven, Belgium; Department of Cellular and Molecular Medicine, KU Leuven, Leuven, BelgiumDepartment of Emergency Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, BelgiumDepartment of Anesthesiology, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Leuven, BelgiumIntroduction: 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, Respiratory failure, Veno-venous extracorporeal membrane oxygenation, Prone ventilationhttp://www.sciencedirect.com/science/article/pii/S2452247319300743 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laurence Carlier Jan Muller Yves Debaveye Sandra Verelst Steffen Rex |
spellingShingle |
Laurence Carlier Jan Muller Yves Debaveye Sandra Verelst Steffen Rex Successful use of VV-ECMO in a pregnant patient with severe ARDS Turkish Journal of Emergency Medicine |
author_facet |
Laurence Carlier Jan Muller Yves Debaveye Sandra Verelst Steffen Rex |
author_sort |
Laurence Carlier |
title |
Successful use of VV-ECMO in a pregnant patient with severe ARDS |
title_short |
Successful use of VV-ECMO in a pregnant patient with severe ARDS |
title_full |
Successful use of VV-ECMO in a pregnant patient with severe ARDS |
title_fullStr |
Successful use of VV-ECMO in a pregnant patient with severe ARDS |
title_full_unstemmed |
Successful use of VV-ECMO in a pregnant patient with severe ARDS |
title_sort |
successful use of vv-ecmo in a pregnant patient with severe ards |
publisher |
Wolters Kluwer Medknow Publications |
series |
Turkish Journal of Emergency Medicine |
issn |
2452-2473 |
publishDate |
2019-07-01 |
description |
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, Respiratory failure, Veno-venous extracorporeal membrane oxygenation, Prone ventilation |
url |
http://www.sciencedirect.com/science/article/pii/S2452247319300743 |
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