Anest. intenziv. Med. 2010;21(5):258-261
Spontaneous delivery during ECMO for H1N1 pneumonia-related ARDS - case reportIntesive Care Medicine - Case Report
- 1 Klinika anestezie, resuscitace a intenzivní medicíny, VFN Praha
- 2 II. interní klinika, VFN Praha
- 3 II. chirurgická klinika kardiovaskulární chirurgie, VFN Praha
- 4 Gynekologicko-porodnická klinika, VFN Praha
Authors present a case report of a woman in the 24th week of pregnancy who acquired intractable swine influenza-related ARDS. Failing conventional ICU therapy including aggressive mechanical ventilation, she was transferred to an ECMO centre where veno-venous (VV) ECMO provided oxygenation and ventilation together with the sanation of the lung injury and barotrauma. Thirty hours post commencing the VV-ECMO she spontaneously delivered. Besides a temporary cessation of the heparin infusion the delivery did not require special measures or changes to the ECMO therapy. The authors discuss the peri-partum issues in pregnant women suffering from severe respiratory failure on VV-ECMO. Complex ultrasound monitoring is highly recommended.
Keywords: extracorporeal membrane oxygenation; ARDS; influenza type A; delivery
Received: May 26, 2010; Accepted: July 6, 2010; Published: October 1, 2010 Show citation
References
- Peek, G. J., Mugford, M., Tiruvoipati, R. et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet, 2009, 374, p. 1351-1363.
Go to original source... 
Go to PubMed... - Davies, A., Jones, D., Balley, M. et al (The Australia and New Zealand Extracorporeal Membrane Oxygenation Influenza Investigators) Extracorporeal Membrane Oxygenation for 2009 influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA, 2009, 302, 17, p. 1888-1895. Go to original source... Go to PubMed...
- Seppelt, I. et al. Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ, 2010, 340, p. 1279. Go to original source... Go to PubMed...
- Lapinsky, S. E. H1N1 novel influenza A in pregnant an immunocompromised patients. Crit. Care Med., 2010, 38, p. e52-57. Go to original source... Go to PubMed...
- Siston, A. M. et al. Pandemic influenza A (H1N1) virus illness among pregnant women in the United States. JAMA, 2010, 303, p. 1517-1525. Go to original source... Go to PubMed...
- Hewagama, S., Walker, S. P., Stuart, R. L. et al. 2009 H1N1 Influenza A and Pregnancy Outcomes in Victoria, Australia. Clin. Infect. Dis., 2010, 50, p. 686-690. Go to original source... Go to PubMed...
- Wheeler, A. P., Bernard, G. R. Acute lung injury and the acute respiratory distress syndrome: a clinical review. Lancet, 2007, 369, p. 1553-1565. Go to original source... Go to PubMed...
- Simhan, N. H., Cartinis, S. N. Prevention preterm delivery. N. Engl. J. Med., 2007, 357, p. 477-487. Go to original source... Go to PubMed...
- Lockwood, C. J., Kuczynski, E. Risk stratification and pathological mechanisms in preterm delivery. Paediatr. Perinat. Epidemiol., 2001, 15, Suppl 2, p. 78-89. Go to original source... Go to PubMed...
- Hájek, Z. a kol. Rizikové a patologické těhotenství. Praha: Grada 2004.
- Sanchez-Ramos, L., Delke, I., Zamora, J., Kaunitz, A. M. Fetal fibronectin as a short-term predictor of preterm birth in symptomatic patients: a meta-analysis. Obstet. Gynecol., 2009, 114, 3, p. 631-640. Go to original source... Go to PubMed...
- Balik, M., Plasil, P., Waldauf, P., Pazout, J., Fric, M., Otahal, M., Pachl, J. Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients. Intensive Care Med., 2006, 32, 2, p. 318-321. Go to original source... Go to PubMed...
- Guillorya, R. K., Gunter, O. L. Ultrasound in the surgical intensive care unit. Current Opinion in Critical Care, 2008, 14, p. 415-422. Go to original source... Go to PubMed...