Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation
Abstract Background Maternal mortality has always been a major medical concern. Recently, the successful application of extracorporeal membrane oxygenation (ECMO) technology in the rescue of near-death patients has been reported. Case presentation This study retrospectively analyzed 5 cases of criti...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-02093-1 |
| _version_ | 1811198336403767296 |
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| author | Ying Li Chi Xu Furong Li Zheng Yan Shugao Ye Jinqi Ma Juan Wen |
| author_facet | Ying Li Chi Xu Furong Li Zheng Yan Shugao Ye Jinqi Ma Juan Wen |
| author_sort | Ying Li |
| collection | DOAJ |
| description | Abstract Background Maternal mortality has always been a major medical concern. Recently, the successful application of extracorporeal membrane oxygenation (ECMO) technology in the rescue of near-death patients has been reported. Case presentation This study retrospectively analyzed 5 cases of critically ill pregnant women/parturients treated with ECMO for respiratory and circulatory failure in the Wuxi People’s Hospital from 2018 to 2020. The mean age of the 5 cases was 30.2 years. Among them, Cases 1 and 5 were treated with Venoarterial (VA) ECMO. Case 1 was diagnosed with congenital heart disease, atrial septal defect, and severe pulmonary hypertension. VA ECMO was applied before cesarean section and was successfully removed after double lung transplantation, but the patient died 10 months after delivery from lung infection. While Case 5 was diagnosed with systemic lupus erythematosus, lupus nephritis, thrombotic vascular disease, HELLP syndrome, and cerebral hemorrhage. VA ECMO was applied 39 days after cesarean section, and the patient died 40 days after delivery due to multiple organ failure. Cases 3 and 4 were treated with Venovenous (VV) ECMO. Case 3 was diagnosed with refractory postpartum hemorrhage, and Case 4 was diagnosed with postpartum hypoglycemic coma, aspiration pneumonia, and shock. They were treated with VV ECMO after delivery, and all survived after successful evacuation. Another Case (Case 2) was diagnosed with postpartum pelvic infection, sepsis and septic shock, and was treated with VA ECMO at 15 days after delivery. The patient changed to VV ECMO at 30 days after delivery due to significant improvement in heart function and poor lung function, but eventually died of multiple organ failure. For the 5 cases, the mean duration of ECMO was 8.7 days, the mean duration of intensive care was 22.0 days, and the mean length of hospital stay was 57.6 days. As a result, 3 patients gradually returned to normal with significant improvement in ventilation and oxygenation after ECMO treatment. Conclusions ECMO technology can be used to treat some of the critical obstetric patients with respiratory and circulatory failure that is ineffective to conventional treatment, but it has no therapeutic effect on the primary disease. |
| first_indexed | 2024-04-12T01:29:44Z |
| format | Article |
| id | doaj.art-7d6c9b0cd78545bca974d17c1beb89d7 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-12T01:29:44Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-7d6c9b0cd78545bca974d17c1beb89d72022-12-22T03:53:32ZengBMCJournal of Cardiothoracic Surgery1749-80902022-12-011711710.1186/s13019-022-02093-1Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenationYing Li0Chi Xu1Furong Li2Zheng Yan3Shugao Ye4Jinqi Ma5Juan Wen6Department of Obstetrics and Gynecology, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityEmergency Department, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Obstetrics and Gynecology, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Critical Care Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityDepartment of Obstetrics and Gynecology, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityNanjing Maternity and Child Health Care Institute, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care HospitalAbstract Background Maternal mortality has always been a major medical concern. Recently, the successful application of extracorporeal membrane oxygenation (ECMO) technology in the rescue of near-death patients has been reported. Case presentation This study retrospectively analyzed 5 cases of critically ill pregnant women/parturients treated with ECMO for respiratory and circulatory failure in the Wuxi People’s Hospital from 2018 to 2020. The mean age of the 5 cases was 30.2 years. Among them, Cases 1 and 5 were treated with Venoarterial (VA) ECMO. Case 1 was diagnosed with congenital heart disease, atrial septal defect, and severe pulmonary hypertension. VA ECMO was applied before cesarean section and was successfully removed after double lung transplantation, but the patient died 10 months after delivery from lung infection. While Case 5 was diagnosed with systemic lupus erythematosus, lupus nephritis, thrombotic vascular disease, HELLP syndrome, and cerebral hemorrhage. VA ECMO was applied 39 days after cesarean section, and the patient died 40 days after delivery due to multiple organ failure. Cases 3 and 4 were treated with Venovenous (VV) ECMO. Case 3 was diagnosed with refractory postpartum hemorrhage, and Case 4 was diagnosed with postpartum hypoglycemic coma, aspiration pneumonia, and shock. They were treated with VV ECMO after delivery, and all survived after successful evacuation. Another Case (Case 2) was diagnosed with postpartum pelvic infection, sepsis and septic shock, and was treated with VA ECMO at 15 days after delivery. The patient changed to VV ECMO at 30 days after delivery due to significant improvement in heart function and poor lung function, but eventually died of multiple organ failure. For the 5 cases, the mean duration of ECMO was 8.7 days, the mean duration of intensive care was 22.0 days, and the mean length of hospital stay was 57.6 days. As a result, 3 patients gradually returned to normal with significant improvement in ventilation and oxygenation after ECMO treatment. Conclusions ECMO technology can be used to treat some of the critical obstetric patients with respiratory and circulatory failure that is ineffective to conventional treatment, but it has no therapeutic effect on the primary disease.https://doi.org/10.1186/s13019-022-02093-1Critically ill pregnant women/parturientsExtracorporeal membrane oxygenationPostpartum hemorrhageRespiratory and circulatory failureChina |
| spellingShingle | Ying Li Chi Xu Furong Li Zheng Yan Shugao Ye Jinqi Ma Juan Wen Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation Journal of Cardiothoracic Surgery Critically ill pregnant women/parturients Extracorporeal membrane oxygenation Postpartum hemorrhage Respiratory and circulatory failure China |
| title | Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation |
| title_full | Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation |
| title_fullStr | Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation |
| title_full_unstemmed | Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation |
| title_short | Five critically ill pregnant women/parturients treated with extracorporeal membrane oxygenation |
| title_sort | five critically ill pregnant women parturients treated with extracorporeal membrane oxygenation |
| topic | Critically ill pregnant women/parturients Extracorporeal membrane oxygenation Postpartum hemorrhage Respiratory and circulatory failure China |
| url | https://doi.org/10.1186/s13019-022-02093-1 |
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