Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA
Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA.
BMJ Case Rep. 2022 May 17;15(5):e249159. doi: 10.1136/bcr-2022-249159.
In critically ill patients with COVID-19, established therapies in the setting of respiratory failure include invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). This case report describes a pregnant woman in her 30s who was hospitalised at 35 weeks gestation with moderate COVID-19 disease. Her condition worsened following delivery, and she required intubation, maximum ventilatory support and ECMO. Because of the severe and irreversible nature of her lung disease, she ultimately underwent bilateral lung transplantation. This case showcases lung transplantation as an alternative life-saving option for patients with severe COVID-19 associated respiratory failure refractory to ECMO and mechanical ventilation. Further studies are needed to develop a multidisciplinary approach for patient selection for transplantation within the context of COVID-19 and to assess long-term outcomes.
在 COVID-19 重症患者中,呼吸衰竭的既定治疗方法包括有创机械通气和体外膜肺氧合(ECMO)。本病例报告描述了一位 30 多岁的孕妇,她在 35 周妊娠时因中度 COVID-19 住院。分娩后病情恶化,需要插管、最大程度的通气支持和 ECMO。由于她的肺部疾病严重且不可逆转,最终她接受了双肺移植。本病例展示了肺移植作为一种挽救生命的替代方法,适用于对 ECMO 和机械通气难治的严重 COVID-19 相关呼吸衰竭患者。需要进一步的研究来制定针对 COVID-19 患者的移植患者选择的多学科方法,并评估长期结果。