ECMO, manejo interinstitucional en puerperio inmediato por SDRA severo secundario a neumonía atípica: reporte de un caso

Abstract

Maternal mortality attributed to severe acute respiratory distress syndrome (ARDS) during pregnancy accounts for approximately 30-50% of all cases in pregnant individuals affected by this condition, while the mortality rate during the puerperal period ranges from 20-25%. Furthermore, there are notable incidences of spontaneous neonatal mortality and preterm births accompanied by disruptions in cardiac rhythm and frequency resulting from maternal hypoxemia.

We present a case study of a 21-year-old female, 37.6 weeks pregnant, who was admitted to a tertiary-level gynecology-obstetrics emergency department with severe ARDS caused by community-acquired atypical pneumonia. The patient necessitated early initiation of extracorporeal membrane oxygenation (ECMO) and was successfully transferred to a designated Center of Excellence for further management. After receiving 37 days of comprehensive supportive care and undergoing successful decannulation, she was discharged home following a total of 68 days of hospitalization.

Severe ARDS represents a clinical entity associated with considerable mortality, particularly within the vulnerable population of pregnant women, significantly impacting the maternal-fetal dyad. The therapeutic escalation, including the incorporation of ECMO, should be readily available in all healthcare facilities. Collaborative efforts among institutions serve as a catalyst for advancements in medical practice, particularly in resource-constrained settings, paralleling the strategies employed in more developed nations.