Extracorporeal membrane oxygenation application in post-partum hemorrhage patients: Is post-partum hemorrhage contraindicated?
Kuan-Ying HuangYi-Ping LiShin-Yu LinJin-Chung ShihYih-Sharng ChenChien-Nan LeePublished in: The journal of obstetrics and gynaecology research (2017)
Extracorporeal membrane oxygenation (ECMO) is commonly used in patients who experience circulatory arrest or significant cardiac dysfunction and is associated with improved clinical outcomes. We conducted a retrospective observational study on ECMO application at a single tertiary center over a five-year period. Five patients who suffered post-partum hemorrhage resulting from uterine atony were treated with ECMO. The mean age was 36.8 ± 3.9 years; the mean gestational age was 37.8 ± 2.2 weeks; the initial mean maternal hemoglobin level was 5.0 ± 2.4 mg/dL; and the mean estimated blood loss was 3260 ± 1545 mL before treatment. All patients were treated with venoarterial ECMO and one was treated with both venoarterial and venovenous ECMO. The mean ECMO usage duration was 32.6 ± 18.8 h (range 10-54). Four (80%) patients survived until discharge without experiencing neurological sequela. ECMO should not be a contraindication for treatment of post-partum hemorrhage and such patients should be weaned as soon as possible to ensure the early recovery of cardiac function.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- end stage renal disease
- newly diagnosed
- respiratory failure
- ejection fraction
- prognostic factors
- gestational age
- peritoneal dialysis
- mechanical ventilation
- cell proliferation
- physical activity
- body mass index
- brain injury
- patient reported outcomes
- patient reported