PMC9364916_01
Sequential chest radiographs during intensive care course while on ECMO.
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PMC9364916_01_gr1.jpg
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Although pronation was initially helpful in improving gas exchange, subsequent pronation after the first trial did not improve gas exchange, which worsened together with progressive infiltrates on chest radiographs (Fig. 1) and worsening lung compliance. Notably, while the patient's CXR radiographic pattern improved around day 36 of disease course (Fig. 1), lung compliance was slower to improve than the radiographs.
Patient timeline. VV-ECMO = venovenous-extracorporeal membrane oxygenations, Trach = tracheostomy, C-section = cesarean section.
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fig2
A 34 year-old gravida 5, para 3 woman with past medical history of hypertension had new symptoms onset in late January 2021 at approximately 20.5 weeks gestation with dyspnea, dry cough, malaise and myalgias (Day 0, see Fig. 2 for clinical timeline). Systemic anticoagulation was initiated concurrent with the institution of ECMO and continued throughout her ECMO course, with exception of the period around her caesarean section delivery (Fig. 2). She continued to improve, with tracheostomy decannulated on day 91, and she was discharged home on day 107 (Fig. 2); her new son joined the patient at home two weeks later.