518: Life-threatening cardiopulmonary failure in pregnancy and the peripartum period: Is extracorporeal life support effective?

Background The use of extracorporeal life support ( ECLS ) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications for ECLS in women during the peripartum period reported in the literature and (2) report maternal and fetal complications and outcomes associated with peripartum ECLS . Methods and Results This review was registered in PROSPERO ( CRD 42018108142). MEDLINE , Embase, and CINAHL were searched for case reports, case series, and studies reporting cases of ECLS during the peripartum period that reported one or more of the following outcomes: maternal survival, maternal complications, fetal survival, and/or fetal complications. Qualitative assessment of 221 publications evaluated the number of cases, clinical details, and maternal and fetal outcomes of ECLS during the peripartum period. There were 358 women included and 68 reported fetal outcomes in cases where the mother was pregnant at the time of cannulation. The aggregate maternal survival at 30 days was 270 (75.4%) and at 1 year was 266 (74.3%); fetal survival was 44 (64.7%). The most common indications for ECLS overall in pregnancy included acute respiratory distress syndrome 177 (49.4%), cardiac failure 67 (18.7%), and cardiac arrest 57 (15.9%). The most common maternal complications included mild to moderate bleeding 66 (18.4%), severe bleeding requiring surgical intervention 48 (13.4%), and intracranial neurologic morbidity 19 (5.3%). The most commonly reported fetal complications included preterm delivery 33 (48.5%) and neonatal intensive care unit admission 19 (27.9%). Conclusions Reported rates of survival in ECLS in pregnant and postpartum women are high and major complications relatively low.

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Faculty Opinions recommendation of Modern use of extracorporeal life support in pregnancy and postpartum.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718886636.793517035 ◽

2016 ◽

Author(s):

Graeme MacLaren

Keyword(s):

Life Support ◽

Extracorporeal Life Support ◽

Pregnancy And Postpartum ◽

In Pregnancy

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Thyroid storm in the second stage of labour: a case report

BMJ Case Reports ◽

10.1136/bcr-2021-243159 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243159

Author(s):

Yudianto Budi Saroyo ◽

Achmad Kemal Harzif ◽

Beryliana Maya Anisa ◽

Fistyanisa Elya Charilda

Keyword(s):

Treatment Guidelines ◽

Thyroid Storm ◽

Lung Oedema ◽

Second Stage ◽

Second Stage Of Labour ◽

Failure Treatment ◽

Life Threatening ◽

Thyroid Hormone Levels ◽

Peripartum Period ◽

In Pregnancy

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.

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Use of Single-Cannula Venous-Venous Extracorporeal Life Support in the Management of Life-Threatening Airway Obstruction

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2014.12.033 ◽

2015 ◽

Vol 99 (3) ◽

pp. e63-e65 ◽

Cited By ~ 14

Author(s):

Michael Ko ◽

Pedro R. dos Santos ◽

Tiago N. Machuca ◽

Katherine Marseu ◽

Thomas K. Waddell ◽

...

Keyword(s):

Airway Obstruction ◽

Life Support ◽

Extracorporeal Life Support ◽

Life Threatening

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Successful treatment of life-threatening ventricular tachycardia with high-dose propranolol under extracorporeal life support and intraaortic balloon pumping.

Japanese Circulation Journal ◽

10.1253/jcj.57.1106 ◽

1993 ◽

Vol 57 (11) ◽

pp. 1106-1110 ◽

Cited By ~ 3

Author(s):

MITSURO KUROSE ◽

KAZUFUMI OKAMOTO ◽

TOSHIHIDE SATO ◽

RIICHIRO YATSUDA ◽

KENICHI OGATA ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Successful Treatment ◽

Life Support ◽

Extracorporeal Life Support ◽

High Dose ◽

Intraaortic Balloon ◽

Intraaortic Balloon Pumping ◽

Life Threatening

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Extracorporeal membrane oxygenation for Kawasaki disease: two case reports and the Extracorporeal Life Support Organization experience 1999–2015

Perfusion ◽

10.1177/0267659117701564 ◽

2017 ◽

Vol 32 (7) ◽

pp. 609-612 ◽

Cited By ~ 2

Author(s):

Derek Best ◽

Johnny Millar ◽

Igor Kornilov ◽

Yury Sinelnikov ◽

Roberto Chiletti ◽

...

Keyword(s):

Kawasaki Disease ◽

Extracorporeal Membrane Oxygenation ◽

Life Support ◽

Extracorporeal Life Support ◽

Case Reports ◽

Membrane Oxygenation ◽

Support Organization ◽

Life Threatening ◽

Acute Kawasaki Disease ◽

Cardiac Manifestations

Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature.

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Clinical Toxicology of Yew Poisoning

Annals of Pharmacotherapy ◽

10.1177/1060028017754225 ◽

2018 ◽

Vol 52 (6) ◽

pp. 591-599 ◽

Cited By ~ 1

Author(s):

Alexander W. Labossiere ◽

Dennis F. Thompson

Keyword(s):

English Language ◽

Life Support ◽

Extracorporeal Life Support ◽

Case Reports ◽

Data Extraction ◽

Case Series ◽

Therapeutic Interventions ◽

Plant Materials ◽

Search Terms ◽

Life Threatening

Objectives: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. Data Sources: PubMed (January 1946 to November 2017) was searched using the search terms “taxus/po”. EMBASE (1980 to November 2017) was searched using the search terms “taxus/to” and “yew.mp.” Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew. Study Selection and Data Extraction: Available English language articles involving case reports, epidemiology, treatment, and outcomes were included. Data Synthesis: Although not uncommon, unintentional yew poisoning rarely results in significant morbidity or mortality. A total of 26 case reports of yew poisoning were evaluated along with 4 case series articles (totaling 22 additional cases). Only 4 of the 48 total cases (8%) were accidental poisonings, the rest being deliberate ingestions. In 20 patients (42%), it resulted in fatalities. Severe, acute yew poisoning results in symptomatology largely resistant to pharmacotherapy intervention. Conclusions: Most nonintentional ingestions of yew plant constituents are asymptomatic and require little intervention. Severe poisoning can result in life-threatening cardiac toxicity and require aggressive supportive care. Therapeutic interventions, such as sodium bicarbonate, digoxin immune fab, and hemodialysis that have been utilized in case studies and case series in the literature have little proven benefit. Extracorporeal life support should be considered in severe yew poisoning.

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Extracorporeal Life Support for Massive Hemoptysis and Acute Lung Injury Due to ANCA Negative Vasculitis

Journal of Anaesthesia and Critical Care Reports ◽

10.13107/jaccr.2021.v07i01.165 ◽

2021 ◽

Vol 7 (1) ◽

Keyword(s):

Acute Lung Injury ◽

Lung Injury ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress ◽

Life Support ◽

Extracorporeal Life Support ◽

Rescue Therapy ◽

Massive Hemoptysis ◽

Life Threatening

Massive hemoptysis is life-threatening and extracorporeal membrane oxygenation (ECMO) may be indicated as rescue therapy due to acute lung injury in this setting. We report a case of a patient who presented with massive hemoptysis and acute lung injury after reported inhaled ground oxymorphone abuse. Although initially thought to have been due to inhaled oxymorphone, we determined that the patient had ANCA-negative vasculitis that led to both hemoptysis and hematuria. The role of inhaled oxymorphone in combination with the vasculitis is unknown. ECMO was initiated to support the patient and, although his course was complicated, he did recover. Keywords: ECMO; Vasculitis; Acute Respiratory Distress (ARDS).

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