Postpartum Extracorporeal Membrane Oxygenation Of A Woman With Covid-19-Related Acute Respiratory Distress Syndrome A Case Report

MEDICINE(2021)

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摘要
Introduction: Patients with coronavirus disease (COVID-19) may develop acute respiratory distress syndrome (ARDS). There have been few reports of postpartum woman with ARDS secondary to COVID-19 who required respiratory support using veno-venous extracorporeal membrane oxygenation (ECMO). We present the case of a 31-year-old woman who was admitted to hospital at 35 weeks gestation with ARDS secondary to COVID-19 and required ECMO during the postpartum period. Patient concerns: The patient had obvious dyspnea, accompanied by chills and fever. Her dyspnea worsened and her arterial oxygen saturation decreased rapidly. Diagnosis: ARDS secondary to COVID-19. Interventions: Emergency bedside cesarean section. Medications included immunotherapy (thymosin alpha 1), antivirals (lopinavir/ritonavir and ribavirin), antibiotics (imipenem-cilastatin sodium and vancomycin), and methylprednisolone. Ventilatory support was provided using invasive mechanical ventilation. This was replaced by venous-venous ECMO 5 days postpartum. ECMO management focused on blood volume control, coagulation function adjustment, and airway management. Outcomes: The patient was successfully weaned for ECMO and the ventilator and made a good recovery. Conclusion: Special care, including blood volume control, coagulation function adjustment, and airway management, should be provided to postpartum patients with ARDS secondary to COVID-19 who require ECMO support.
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acute respiratory distress syndrome, case report, COVID-19, extracorporeal membrane oxygenation, postpartum
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