Successful use of extracorporeal membrane oxygenation in the reversal of cardiorespiratory failure induced by atonic uterine bleeding: a case report

Journal of Medical Case Reports

Masaji Nishimura²  Hideaki Imanaka¹  Emiko Nakataki²  Nao Okuda²  Mutsuo Onodera²  Taiga Itagaki² 

[1] Department of Emergency and Disaster Medicine, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima 7708503, Japan;Department of Emergency and Critical Care Medicine, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima 7708503, Japan

关键词: Extracorporeal membrane oxygenation;    Cardiorespiratory failure;    Atonic uterine bleeding;   

Others  :  822883
DOI  :  10.1186/1752-1947-8-23

 received in 2013-08-09, accepted in 2013-11-19,  发布年份 2014

【 摘 要 】

Introduction

Although extracorporeal membrane oxygenation has made sufficient progress to be considered for the management of life-threatening cardiac and respiratory failure, the risk of hemorrhagic complications may outweigh the benefits for patients with bleeding tendencies. We report, to the best of our knowledge, the first case of successful treatment by extracorporeal membrane oxygenation, without any hemorrhagic complications, of postpartum cardiorespiratory failure after massive uterine bleeding.

Case presentation

A 25-year-old Japanese woman experienced massive atonic bleeding after delivering her second baby. Recovery from hemorrhagic shock was managed by conservative treatments, but she developed decompensated heart failure and refractory hypoxia. Because we could not obtain hemodynamic stability and proper oxygenation even with high doses of catecholamines and maximal ventilator settings, we administered venoarterial extracorporeal membrane oxygenation, whereupon her hemodynamic status immediately stabilized. After 72 hours of support without major bleeding, extracorporeal membrane oxygenation was successfully withdrawn.

Conclusion

Even in cases of obstetric bleeding, if clotting status is stringently monitored, extracorporeal membrane oxygenation can be considered as an ultimate means of life support.

【 授权许可】

   
2014 Itagaki et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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