Revised: February 18, 2013
Accepted: March 9, 2013
Published online: March 28, 2013
We report the outcome of a pregnant woman with a life-threatening acute respiratory distress syndrome from a novel influenza A (H1N1) virus infection 3 d postpartum successfully managed by veno-arterial extracorporeal membrane oxygenation. The patient was successfully weaned from extracorporeal membrane oxygenation (ECMO) on day 10. Novel H1N1 virus infection was identified by real-time reverse transcription-polymerase chain reaction. Veno-arterial ECMO in this patient carried a number of specific advantages namely maintaining haemodynamic stability obviating the need for inotrope support and improving oxygenation compared to alternative approaches such as veno-venous ECMO and pumpless devices. Femoral arterial and venous cannulae were inserted in a pure percutaneous method allowing rapid establishment of extracorporeal circulation. Given the high mortality of acute respiratory distress syndrome following novel H1N1 virus infection, we advocate the use of ECMO when conventional mechanical ventilation fails.
Core tip: Novel influenza A virus infection can result in acute respiratory distress syndrome extremely difficult to manage with conventional mechanical ventilation and non-invasive therapy. Veno-arterial extracorporeal membrane oxygenation can provide respiratory and circulatory support in these patients. We successfully weaned a postpartum patient after 10 d of extracorporeal membrane oxygenation. Furthermore, by employing the pure percutaneous method of cannulae insertion, we minimized implantation time and trauma.