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Successful recovery of a critically ill pregnant covid-19 patient treated with extracorporeal membrane oxygenation (ECMO) in Sanglah General Hospital, Bali, Indonesia: A case report
I Made Susila Utama1, Cokorda Agung Wahyu Purnamasidhi1, Putu Agus Surya Panji2, Made Bagus Dwi Aryana3, Komang Adhi Parama Harta4
1 Tropical and Infectious Diseases Division, Internal Medicine Department, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia
2 Anesthesiology and Reanimation Department, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia
3 Obstetrics and Gynecology Department, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia
4 Cardiothoracic Surgery Department, Udayana University/Sanglah General Hospital, Denpasar, Bali, Indonesia
Correspondence Address:
I Made Susila Utama
Tropical and Infectious Diseases Division, Internal Medicine Department, Udayana University/Sanglah General Hospital, Denpasar, Bali
Indonesia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/bjoa.bjoa_164_22
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Extracorporeal membrane oxygenation (ECMO) has been shown to be effective as a form of a life-sustaining modality in previous outbreaks such as Middle East respiratory syndromes covariant and H1N1. A 28-year-old woman was referred from a military hospital after experiencing prolonged dyspnea and a loss of consciousness. At the time of admission, the patient was pregnant with a gestational age of 24–25 weeks and has a history of hypertension and a caesarian section. Respiratory failure forced a caesarean section, which was followed by an intensive care unit admission. Five days after admission, the patient was placed on ECMO with a heparin drip. The patient suffered coinfections identified in the patient’s sputum, blood, and urine samples. Significant clinical improvement observed after the second ECMO weaning and was followed by successful discharge. The successful treatment of a critically ill COVID-19 pregnant patient with ECMO as a life-sustaining critical-care modality is uncommon. However, potential coinfections must be considered, and physicians must prepare for waves of clinical worsening and improvement. |
