Professional paper
Life saving use of ECMO in an obstetric patient with massive hemorrhage following uterine atony: a case report
Alan Šustić
; Department of Anesthesiology and ICU University Hospital of Rijeka T. Strizica 3. 51 000 Rijeka. Croatia
Abstract
The aim of this case report is to present the life saving use of extracorporeal membrane oxygenation (ECMO) in an obstetric patient with acute cardiorespiratory collapse following massive bleeding caused by an atonic uterus post partum. A 39-year-old patient, following a spontaneous abortion at 21 weeks of pregnancy, developed uterine atony and massive bleeding and was ultimately referred to the operating room for an emergent hysterectomy. Postoperatively, she was referred to the intensive care unit (ICU) where she developed severe acute respiratory distress syndrome (ARDS) that was successfully treated by employing ECMO. Following discontinuation of ECMO, her treatment was further complicated by a manifest hemolytic transfusion reaction. Although extensive testing was done to establish the cause of this reaction, we were unable to find it. The patient responded well to treatment with erythropoietin (EPO) and corticosteroids as well as a restrictive transfusion regime. This treatment pointed to a possible immune reaction to massive transfusions of blood products. This case demonstrated the importance of early aggressive treatment using ECMO in reversal of life threatening ARDS, as well as the need for a judicious approach when transfusing blood products.
Keywords
ECMO (extracorporeal membrane oxygenation); hemorrhagic diathesis; obstetric patients
Hrčak ID:
170204
URI
Publication date:
1.9.2016.
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