Extracorporeal Membrane Oxygenation Utilization in Pregnant and Post-Partum Patients During the Covid-19 Pandemic

ABSTRACT

The use of veno-venous extracorporporeal membrane oxygenation (ECMO) support quickly became instrumental in treating a wide-range of patients demographics, including peripartum, that became critically ill with COVID pneumonia. Despite the surge in VV ECMO support throughout the pandemic data remains limited on safety and efficacy as a treatment modality in peripartum patients. A systematic review of all peripartum patients that were placed on VV ECMO support for COVID-19 pneumonia at a single institution from March 2020 to April 2022. Patient demographics, peripartum status, length of ECMO run, survival to discharge rates and associated complications with ECMO support were extracted through EMR and analyzed. Ten patients in the peripartum phase were included in the study. Mean age 35(±5.8) with mean body mass index 37.2(±11.4). Prior to ECMO insertion eight patients had infant delivery with a mean gestational age of 29.6(±3.2) weeks. Two patients were placed on ECMO at 19 and 28 weeks gestational age. Pre-ECMO patient presentation;All patients were on mechanical ventilation at 100% FiO2 , 5 had neuromuscular blockade infusions, 7 required inhaled nitric oxide, and the mean PaO2/FiO2 ratio was 86.7(95% CI 73.9-99.5). Mean predicted mortality scores at ECMO insertion were RESP 3.8(95% CI 2.8-4.8) and Murray 3.72(95% CI 3.6-3.8) respectively. Overall maternal and infant survival to discharge was 100%. Mean VA ECMO run was 18.5 days (±10.3) with mean hospital length of stay of 28.2 days (±11.5). Based on our findings, the use of VV ECMO support within this previously understudied patient population has proven to be a safe and an effective intervention. We should encourage clinicians to consider using VV ECMO in any peripartum patients who develop refractory ARDS in order to increase chance at survival. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)