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There are limited data on the use of extracorporeal membrane oxygenation (ECMO) for pregnant and peripartum women with COVID-19 associated acute respiratory distress syndrome (ARDS). Pregnant women may exhibit more severe infections with COVID-19, requiring intensive care. We supported nine pregnant or peripartum women with COVID-19 ARDS with ECMO, all surviving and suffering no major complications from ECMO. Our case series demonstrates high-maternal survival rates with ECMO support in the management of COVID-19 associated severe ARDS, highlighting that these pregnant and postpartum patients should be supported with ECMO during this pandemic.

Abstract-Orthostatic hypotension (OH) can cause syncope that is difficult to treat. We have found that 473 mL (16 oz) of water can increase systolic blood pressure (SBP) by Ͼ30 mm Hg in many OH patients (the gastropressor response). OH patients are routinely advised to increase their sodium intake to augment their blood volume. We tested the hypothesis that the ingestion of salt with water would increase the magnitude of the acute pressor response compared with water alone in patients with OH. Key Words: blood pressure Ⅲ sympathetic nervous system Ⅲ sodium Ⅲ hypotension Ⅲ autonomic nervous system Ⅲ water-electrolyte balance O rthostatic hypotension (OH) can be a debilitating condition that is difficult to treat. 1-8 Oral water ingestion has been shown to effect a large pressor response in patients with neurogenic OH, 9 -13 with some patients experiencing increases of Ͼ40 mm Hg in their systolic blood pressure (SBP). 9 This gastropressor response takes place over minutes rather than seconds, with a peak effect between 20 and 40 minutes after the water ingestion. 9,10 The oral route is important, because the increase in SBP was only one-third as great with identical volumes of intravenous 5% dextrose in water (D5W) versus oral water. 10

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