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Case Report

Open Access

Life saving use of ECMO in an obstetric patient with massive hemorrhage following uterine atony: a case report

  • BERISLAV BARBALIĆ1
  • VLATKA SOTOŠEK TOKMADŽIĆ1
  • OLEG PETROVIĆ1
  • IRENA BOŽANIĆ KRIČKA1
  • ALAN ŠUSTIĆ1

1 Department of Anesthesiology and ICU, University Hospital Rijeka, Rijeka, Croatia

2 Department of Gynecology and obstetrics, University Hospital Rijeka, Rijeka, Croatia

DOI: 10.22514/SV121.102016.22 Vol.12,Issue S1,October 2016 pp.121-124

Published: 10 October 2016

*Corresponding Author(s): ALAN ŠUSTIĆ E-mail: alan.sustic@uniri.hr

PDF (271.64 kB)

Abstract

The aim of this case report is to present the life saving use of extracorporeal membrane oxygenation (ECMO) in an obstetric pa-tient with acute cardiorespiratory collapse following massive bleeding caused by an atonic uterus post partum. A 39-year-old patient, following a spontaneous abor-tion at 21 weeks of pregnancy, developed uterine atony and massive bleeding and was ultimately referred to the operating room for an emergent hysterectomy. Post-operatively, she was referred to the inten-sive care unit (ICU) where she developed severe acute respiratory distress syndrome (ARDS) that was successfully treated by employing ECMO. Following discontinu-ation of ECMO, her treatment was further complicated by a manifest hemolytic trans-fusion reaction. Although extensive testing was done to establish the cause of this reac-tion, we were unable to find it. The patient responded well to treatment with erythro-poietin (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 im-portance of early aggressive treatment us-ing ECMO in reversal of life threatening ARDS, as well as the need for a judicious approach when transfusing blood prod-ucts.

Key words

ECMO (extracorporeal mem-brane oxygenation), hemorrhagic diathesis, obstetric patients

Cite And Share

BERISLAV BARBALIĆ,VLATKA SOTOŠEK TOKMADŽIĆ,OLEG PETROVIĆ,IRENA BOŽANIĆ KRIČKA,ALAN ŠUSTIĆ. Life saving use of ECMO in an obstetric patient with massive hemorrhage following uterine atony: a case report. Signa Vitae. 2016. 12(S1);121-124.

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