First successful treatment of a COVID-19 pregnant woman with severe ARDS by combining early mechanical ventilation and ECMO.
Liusheng Hou, Mingxing Li, Kai Guo and 4 others
PMID 32948334WHAT IT FOUND
A pregnant woman with severe COVID-19 ARDS survived after intubation, mechanical ventilation, emergency cesarean, and later ECMO.
This is one case, not evidence the combination works.
Key findings
01The patient was admitted to the ICU and received tracheal intubation, mechanical ventilation, and emergency cesarean section.
02On day 6, with FiO2 100% and PEEP 16 cmH2O, blood gas showed pH 7.15, PO2 62 mmHg, and PCO2 68 mmHg, then ECMO was performed.
03ECMO was withdrawn on day 27, the ventilator was weaned on day 38, and the patient was in good health at one-month follow-up after discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only one patient was reported, so it cannot show that the treatments worked or who they would help. The patient received several treatments close together: high-flow oxygen, intubation, mechanical ventilation, cesarean section, ECMO, sedation, lung-protective ventilation, and negative fluid balance. The report cannot separate their contributions. There was no comparison group or control, so improvement cannot be measured against usual care. The Discussion offers explanations for the outcome, but these are not tested in this report. Follow-up was only one month after discharge, and the baby's outcome is not reported.
Declared interests
The authors declare no financial or personal relationships with other people or organizations that could inappropriately influence the work.
The easy way to misread this
Do not read this as proof that early mechanical ventilation and ECMO caused survival. The report describes one patient who also received high-flow oxygen, emergency cesarean, sedation, lung-protective ventilation, and negative fluid balance, and it has no comparison group.