Recenzija, prikaz
https://doi.org/10.20471/acc.2023.62.s1.21
Whole Range of Respiratory Support in a Pregnant Woman with a Severe Form of COVID-19 Infection: A Case Report
Sanja Berić
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Višnja Nesek Adam
orcid.org/0000-0002-6521-4136
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Libertas International University, Zagreb, Croatia
Ivan Šklebar
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Catholic University of Croatia, Zagreb, Croatia; Bjelovar University of Applied Sciences, Bjelovar, Croatia
Tino Klancir
orcid.org/0009-0005-1949-6231
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia
Mark Žižak
orcid.org/0009-0005-2140-0147
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia
Marin Mličević
; Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia
Sažetak
Acute respiratory syndrome caused by a novel coronavirus (SARS-CoV-2) in
pregnant women can progress to a critical condition. In this paper, we present a case of a woman in the
28th week of gestation hospitalized due to respiratory insufficiency caused by COVID-19 infection
and consequent bilateral pneumonia with development of severe acute respiratory distress syndrome.
Noninvasive ventilation through a face mask was started but due to progression of respiratory insufficiency
with high FiO2 and positive end expiratory pressure (PEEP), we decided to intubate the
patient, after which obstetricians agreed to complete pregnancy by cesarean section. The clinical course
was complicated by desaturation and bradycardia with recurring asystole which recovered after the use
of atropine. The patient was increasingly difficult to mechanically ventilate on the PSIMV modality
(tidal volume [TV] <200 mL). She was switched to ASV modality (TV up to a maximum of 350 mL,
ASV 130%, PEEP 16 cm H2O, FiO2 100%, RR 25/min, pPeak 35 cm H2O, pPlateau 35 cm H2O),
after which peripheral saturation recovered to 89%. Due to inadequate mechanical ventilation, the
patient was transferred to Dr. Fran Mihaljević University Hospital for Infectious Diseases in order to
perform extracorporeal membrane oxygenation (ECMO). Owing to all of the measures taken, recovery
followed after 13 days on ECMO.
Ključne riječi
COVID-19; Pregnancy; Cesarean section; Spontaneous pneumothorax; ARDS; ECMO
Hrčak ID:
307564
URI
Datum izdavanja:
1.4.2023.
Posjeta: 287 *