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Review

The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation

by
Alexandre Pelouze
1,*,
Sylvain Massias
1,
Diae El Manser
1,
Adrien Koeltz
1,
Patricia Shri Balram Christophe
1,
Mohamed Soualhi
1 and
Marc Licker
1,2
1
Department of Cardiovascular & Thoracic Anaesthesia and Critical Care, University Hospital of Martinique, F-97200 Fort-de-France, Martinique, France
2
Faculty of Medicine, University of Geneva, CH-1206 Geneva, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(1), 213; https://doi.org/10.3390/jcm14010213
Submission received: 24 October 2024 / Revised: 5 December 2024 / Accepted: 30 December 2024 / Published: 2 January 2025
(This article belongs to the Special Issue Clinical Advances in Cardiac Anesthesia and Critical Care)
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Abstract

Acute cardiovascular disorders are incriminated in up to 33% of maternal deaths, and the presence of sickle cell anemia (SCA) aggravates the risk of peripartum complications. Herein, we present a 24-year-old Caribbean woman with known SCA who developed a vaso-occlusive crisis at 36 weeks of gestation that required emergency Cesarean section. In the early postpartum period, she experienced fever with rapid onset of acute respiratory distress in the context of COVID-19 infection that required tracheal intubation and mechanical ventilatory support with broad-spectrum antibiotics and blood exchange transfusion. Shortly thereafter, transthoracic echocardiography documented severe biventricular dysfunction associated with raising levels of cardiac troponin and ECG signs of myocardial ischemia. Medical treatment with incremental dobutamine and noradrenaline infusion failed to improve cardiac output and blood gas exchange. After consultation with the regional cardiac center, a prompt decision was made to provide cardiac and respiratory support via implantation of femoral cannula and initiation of veno-arterial extracorporeal membrane oxygenation (ECMO, Cardiohelp®). Under stable ECMO, the patient was transferred by helicopter to a specialized cardiac center. There were no signs of ongoing hemolysis, and progressive recovery of the right and left ventricular function facilitated forward blood flow through the aortic valve. Three days after implantation, ECMO was weaned, and the cannula were removed. One day later, the patient’s chest X-rays showed partial resolution of lung edema. The patient was successfully extubated, and non-invasive ventilation with pulmonary rehabilitation was initiated to speed up her functional recovery.
Keywords: cardiogenic shock; pregnancy; extracorporeal life support; sickle cell anemia; Afro-Caribbean ethnicity cardiogenic shock; pregnancy; extracorporeal life support; sickle cell anemia; Afro-Caribbean ethnicity

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MDPI and ACS Style

Pelouze, A.; Massias, S.; El Manser, D.; Koeltz, A.; Balram Christophe, P.S.; Soualhi, M.; Licker, M. The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation. J. Clin. Med. 2025, 14, 213. https://doi.org/10.3390/jcm14010213

AMA Style

Pelouze A, Massias S, El Manser D, Koeltz A, Balram Christophe PS, Soualhi M, Licker M. The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation. Journal of Clinical Medicine. 2025; 14(1):213. https://doi.org/10.3390/jcm14010213

Chicago/Turabian Style

Pelouze, Alexandre, Sylvain Massias, Diae El Manser, Adrien Koeltz, Patricia Shri Balram Christophe, Mohamed Soualhi, and Marc Licker. 2025. "The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation" Journal of Clinical Medicine 14, no. 1: 213. https://doi.org/10.3390/jcm14010213

APA Style

Pelouze, A., Massias, S., El Manser, D., Koeltz, A., Balram Christophe, P. S., Soualhi, M., & Licker, M. (2025). The Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation. Journal of Clinical Medicine, 14(1), 213. https://doi.org/10.3390/jcm14010213

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