Successfully treated severe obstetric sepsis and acute respiratory distress syndrome with extracorporeal membrane oxygenation

Benetis, Rimantas; Nadišauskienė, Rūta Jolanta; Širvinskas, Edmundas; Lenkutis, Tadas; Siudikas, Adakrius; Kadusauskaitė, Vytaute; Railaitė, Dalia Regina; Sukovas, Artūras; Abraitis, Vytautas

doi:10.1177/0267659115605885

Cited by 6 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, a third case of an 18-year-old nulliparous woman was reported [23]. She was admitted after 26 weeks of pregnancy with high fever, nausea, headache and increasing inflammatory parameters.…”

Section: Advances In Extra-corporeal Perfusion Therapiesmentioning

confidence: 97%

See 1 more Smart Citation

Use of ECMO in Sepsis and Septic Shock

Decker¹

2019

Advances in Extra-Corporeal Perfusion Therapies

View full text Add to dashboard Cite

The use of extracorporeal membrane oxygenation (ECMO) has always been controversial in the past. Evidence was mainly build up in neonates and much controversy remained in adults. The main adult indications were mechanical support (e.g., in cardiogenic shock) or respiratory support (e.g., in the field of acute respiratory distress syndrome (ARDS)). Sepsis was historically often considered as a contraindication. As a consequence of several worldwide flu outbreaks, the use of ECMO in infectious diseases increased. Besides in these viral infections, there was also growing interest for its use in bacterial septicemia, although often as escape therapy. In the recent years, other techniques gained increasing interest like for example, immunoadsorption, implemented in dialysis or ECMO circuits. In this chapter, we resume the available literature on the use of ECMO in septic shock including the use of immunoadsorption techniques.

show abstract

Section: Advances In Extra-corporeal Perfusion Therapiesmentioning

confidence: 97%

“…Due the necessity of anticoagulating ECMO treated patients, this is not without risk of bleeding during or after (at restart of anticoagulation) the procedure. However, as mentioned in previous sections of this chapter, performing surgical procedures in ECMO patients is feasible [22,23].…”

Section: Source Controlmentioning

confidence: 99%

Use of ECMO in Sepsis and Septic Shock

Decker¹

2019

Advances in Extra-Corporeal Perfusion Therapies

View full text Add to dashboard Cite

show abstract

“…Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency to support obstetric patients with severe cardiac or pulmonary failure, which is most likely the only option to save the life of those patients [1][2][3]. Here the authors present four cases who treated ECMO in obstetric emergencies with unexpected refractory shock.…”

Section: Introductionmentioning

confidence: 99%

The role of extracorporeal membrane oxygenation in obstetric emergencies with unexpected refractory shock

Ju¹,

Hyun²,

Dong-Hyung³

et al. 2018

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency to support obstetric patients with severe cardiac or pulmonary failure. Particularly, ECMO is required for successful cardiopulmonary resuscitation in cases of obstetric emergencies with unexpected refractory shock, which is most likely the only option to save the life of those patients. Here the authors present four cases who were treated with ECMO for cardiorespiratory support in obstetric emergencies with unexpected refractory shock. In conclusion, ECMO could be a valuable means of bridging therapy to save the life of a patient with obstetric emergencies who develops cardiopulmonary collapse.

show abstract

Heparin

2021

Reactions Weekly

View full text Add to dashboard Cite

Bleeding at the site cannulation in subclavian artery and pulmonary bleeding: case reportAn 18-year-old woman developed bleeding at the site of the subclavian artery and pulmonary bleeding during anticoagulant treatment with heparin for extracorporeal membrane oxygenation (ECMO).The pregnant woman was admitted to the hospital in Lithuania on 19 October 2012 at gestational weeks 27. She had a high fever, pain in her lower back and abdomen, headache, nausea and dizziness. The blood tests revealed elevated inflammatory markers. The specimen for blood culture was taken, and she started receiving empirical treatment with IV cefuroxime 750mg every 8h. An ultrasound of the fetus revealed breech presentation, with the amniotic fluid index normal. On admission day 2, she delivered a baby girl via C-section due to breech presentation. The neonate's birthweight was 1562g and an Apgar score was 7-8. An unpleasant smell and turbid excreta appeared straight after the separation of the placenta from the wall of the uterus. Surgery was finished without complications. However, the mother suddenly experienced significant tachycardia and specimen for blood culture was taken. After 45 minutes of surgery, she developed disseminated intravascular coagulation (DIC) leading to massive bleeding. It was concluded that sepsis provoked the DIC. Her antibacterial therapy was immediately changed from cefuroxime to vancomycin and meropenem. She was transferred to the ICU due to pulmonary oedema which had started four hours after the bleeding. She developed acute cardiopulmonary failure and septic shock, requiring intubation, mechanical ventilation and vasopressor support. Blood culture results were received and both were positive. Staphylococcus aureus was in the first culture, which had been taken after the woman's admission to hospital. Two different strains of Enterobacter cloacea were in the second culture, which had been taken during the C-section. As a result of uterine infection, she underwent a hysterectomy on the fourth day after the C-section resulting in slight recovery. On day 3 after the hysterectomy, her respiratory function deteriorated due to acute respiratory distress syndrome (ARDS). She developed permissive hypercapnia and haemodynamic instability requiring norepinephrine. Therefore, she was initiated on ECMO under heparin anticoagulation [dosage and route not stated]. As a result of heparin, she developed bleeding and haematoma at the site of the subclavian artery where the ECMO cannula was inserted [duration of treatment to reaction onset not stated]. Moreover, she had infection of haematoma and septicaemia with Enterobacter spp. was observed.The woman's antibacterial treatment was adjusted to imipenem and vancomycin. A thoracotomy was performed and the haematoma removed. The postoperative period was complicated with a severe pulmonary bleeding episode requiring several rethoracotomies. While maintaining hypocoagulation for the ECMO, pulmonary bleeding continued leading to a new haematoma. She again underwent a thoracotomy...

show abstract

Successfully treated severe obstetric sepsis and acute respiratory distress syndrome with extracorporeal membrane oxygenation

Cited by 6 publications

References 9 publications

Use of ECMO in Sepsis and Septic Shock

Use of ECMO in Sepsis and Septic Shock

The role of extracorporeal membrane oxygenation in obstetric emergencies with unexpected refractory shock

Heparin

Contact Info

Product

Resources

About