Successful provision of inter-hospital extracorporeal cardiopulmonary resuscitation for acute post-partum pulmonary embolism

McDonald, C., Laurie, J., Janssens, S., Zazulak, C., Kotze, P. and Shekar, K. (2017) Successful provision of inter-hospital extracorporeal cardiopulmonary resuscitation for acute post-partum pulmonary embolism. International Journal of Obstetric Anesthesia, 30 65-68. doi:10.1016/j.ijoa.2017.01.003

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Author McDonald, C.
Laurie, J.
Janssens, S.
Zazulak, C.
Kotze, P.
Shekar, K.
Title Successful provision of inter-hospital extracorporeal cardiopulmonary resuscitation for acute post-partum pulmonary embolism
Journal name International Journal of Obstetric Anesthesia   Check publisher's open access policy
ISSN 1532-3374
0959-289X
Publication date 2017-05-01
Year available 2017
Sub-type Article (original research)
DOI 10.1016/j.ijoa.2017.01.003
Open Access Status File (Author Post-print)
Volume 30
Start page 65
End page 68
Total pages 4
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 2729 Obstetrics and Gynaecology
2703 Anesthesiology and Pain Medicine
Abstract Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived. Following ECMO support, the patient experienced massive hemorrhage which was managed with uterotonic agents, targeted transfusion, bilateral uterine artery embolisation and abdominal re-exploration. The patient was transferred to an adult unit where she remained on ECMO for five days. She was discharged home with normal cognitive function. This case highlights the role ECMO plays in providing extracorporeal respiratory or mechanical circulatory support in a high risk obstetric patient.
Keyword Extracorporeal cardiopulmonary resuscitation
Extracorporeal membrane oxygenation
Post-partum
Pulmonary embolism
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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