Karic Edin, Mitwally Hassan, Alansari Lolwa M, Ganaw Adel, Saad Mohamed O, Azhaghdani Abdulhamid
Critical Care Medicine, Hamad Medical Corporation, Al Wakra, QAT.
Pharmacy, Hamad Medical Corporation, Al Wakra, QAT.
Cureus. 2022 Sep 26;14(9):e29633. doi: 10.7759/cureus.29633. eCollection 2022 Sep.
Pregnant women are at high risk of coronavirus disease 2019 (COVID-19) complications, including acute respiratory distress syndrome (ARDS) and the need for mechanical ventilation. There is no literature on the optimal strategy for the management of difficult-to-wean pregnant and early postpartum patients. We report two cases of pregnant women with COVID-19 pneumonia and ARDS, who required mechanical ventilation and high doses of analgesia, and sedation with neuromuscular blocking agents to facilitate ventilation and oxygenation. Both patients had a tracheostomy procedure to facilitate weaning from mechanical ventilation and sedation. Shortly after tracheostomy, sedation and analgesia, along with ventilatory support were weaned off. Both patients were discharged home. These cases propose early tracheostomy as a strategy to facilitate weaning from mechanical ventilation and sedation in pregnant and early postpartum patients.
孕妇感染2019冠状病毒病（COVID-19）出现并发症的风险很高，包括急性呼吸窘迫综合征（ARDS）以及需要机械通气。目前尚无关于难以脱机的孕妇和产后早期患者管理的最佳策略的文献。我们报告了两例COVID-19肺炎合并ARDS的孕妇病例，她们需要机械通气、高剂量镇痛以及使用神经肌肉阻滞剂进行镇静以促进通气和氧合。两名患者均接受了气管切开术以促进机械通气和镇静的脱机。气管切开术后不久，镇静和镇痛以及通气支持均逐渐减少。两名患者均出院回家。这些病例提出早期气管切开术可作为促进孕妇和产后早期患者机械通气和镇静脱机的一种策略。
