КЛИНИЧЕСКИЙ СЛУЧАЙ ТЯЖЕЛОГО ТЕЧЕНИЯ ИНФЕКЦИИ COVID-19 У РОДИЛЬНИЦЫ В РАННЕМ ПОСЛЕРОДОВОМ ПЕРИОДЕ С ПРИМЕНЕНИЕМ ЭКСТРАКОРПОРАЛЬНОЙ МЕМБРАННОЙ ОКСИГЕНАЦИИ

Abstract

A new coronavirus infection (COVID-19) raises reasonable concerns about the impact of the Sars-CoV-2 virus on pregnant women and women in the postpartum period, given the high risk of COVID-19-associated acute respiratory distress syndrome with refractory hypoxemia, even against the background of artificial lung ventilation. When this situation arises, the use of Extracorporeal membrane oxygenation (ECMO) is justified to improve respiratory function and support blood circulation. In the given clinical case, the experience of successful treatment of a patient with COVID-19 infection in the early postpartum period with ECMO for 22 days, who was hospitalized at the Grodno Regional Clinical Cardiology Center, is presented. In the current clinical situation, all methods of respiratory support have been consistently used: from oxygen therapy through high-flow ventilation and non-invasive mechanical ventilation, to invasive mechanical ventilation. During her stay on ECMO, the patient experienced two hemorrhagic events that required surgical interventions. During therapy, it was possible to avoid thrombosis of the circuit and prevent the development of rebleeding against the background of anticoagulant therapy by carefully monitoring the hemostasis system using clotting hemostasiological tests and ROTEM indicators and correcting their violations.