ECMO is an effective rescue therapy for pregnant and postpartum patients with severe cardiopulmonary dysfunction, and it has been increasingly utilized over the past 2 decades. Maternal and fetal outcomes after ECMO support have steadily improved during this time, and ongoing experience with this form of life support will continue to inform practice. Survival can be bolstered by early recognition of maternal critical illness and referral to a specialized center with expertise in ECMO and high-risk obstetrics. Multidisciplinary collaboration is essential given the complex interplay of maternal and ECMO physiology.
APACHE = Acute Physiology and Chronic Health Evaluation; APRV = airway pressure release ventilation; aPTT = activated partial thromboplastin time; ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus disease 2019; ECMO = extracorporeal membrane oxygenation; ELSO = Extracorporeal Life Support Organization; FIGO = International Federation of Gynecology and Obstetrics; FIO 2 = fraction of inspired oxygen; Hco3 = bicarbonate; HIT = heparin-induced thrombocytopenia; ICU = intensive care unit; MERS = Middle East respiratory syndrome; PEEP = positive end-expiratory pressure; Pplat = plateau pressure; Sao2 = arterial oxygen saturation; SAPS-2 = Simplified Acute Physiology Score; SARS = severe acute respiratory syndrome; SOFA = Sequential Organ Failure Assessment; VAD = ventricular assist device; VA-ECMO = venoarterial ECMO; VV-ECMO = venovenous ECMO
Support was provided solely from institutional and/or departmental sources.
The authors thank Sahana Bharadwaj for producing schematics to demonstrate ECMO cannula configurations and padding for prone positioning.
Anesth Analg. 2022;135(2):277-289. © 2022 International Anesthesia Research Society