体外膜肺氧合成功用于围产前期哮喘持续状态孕妇
Successful Use of Extracorporeal Membrane Oxygenation for Status Asthmaticus in a Woman With a Periviable Pregnancy.
机构信息
Department of Obstetrics and Gynecology and the Division of Maternal-Fetal Medicine, Tufts Medical Center, Boston, Massachusetts.
出版信息
Obstet Gynecol. 2018 Oct;132(4):1007-1010. doi: 10.1097/AOG.0000000000002799.
BACKGROUND
Status asthmaticus is a severe asthma exacerbation with persistent airway obstruction despite standard therapy. Use of extracorporeal membrane oxygenation (ECMO) as rescue therapy in pregnancy is exceedingly rare. We describe a case of ECMO for treatment of status asthmaticus in woman with a periviable pregnancy culminating in a term delivery.
CASE
The patient was a 33-year-old woman, gravida 3 para 1, admitted at 23 2/7 weeks of gestation with respiratory failure secondary to status asthmaticus. Venovenous ECMO was initiated and continued for 6 days. After hospital discharge, she had no further respiratory issues. She ultimately developed fetal growth restriction and gestational hypertension and underwent a repeat cesarean delivery at 38 weeks of gestation.
CONCLUSION
Venovenous ECMO can be used successfully for status asthmaticus during a periviable pregnancy and enable delivery at term.
背景
尽管采用了标准治疗，但哮喘持续状态仍表现为持续性气道阻塞，属于严重的哮喘恶化。在妊娠期间，将体外膜氧合（ECMO）用作抢救治疗的情况极为罕见。我们描述了一例 ECMO 治疗极早产儿妊娠合并哮喘持续状态的病例，最终成功分娩足月婴儿。
病例
患者为 33 岁女性，孕 3 产 1，妊娠 23 周+2 天因哮喘持续状态导致呼吸衰竭而入院。给予静脉-静脉 ECMO 治疗，并持续 6 天。出院后，她的呼吸系统问题没有再出现。她最终发展为胎儿生长受限和妊娠高血压，并在 38 周妊娠时再次行剖宫产术。
结论
静脉-静脉 ECMO 可成功用于极早产儿妊娠合并哮喘持续状态，并能实现足月分娩。
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