The Use of Extracorporeal Membrane Oxygenation in a Patient with Septic Myocarditis in the Postpartum Period

Abstract

Introduction. Septic myocarditis is a rare disease (from 10 to 22 cases per 100 000 people). The cause of death is usually acute heart failure, hemodynamically significant cardiac arrhythmias, or thromboembolism. Patients in critical condition suffering from infectious myocarditis require massive cardiotonic support to maintain the necessary cardiac output with reduced myocardial contractile function, which leads to an increase in the need for cardiomyocytes for oxygen and aggravates their damage. Veno-arterial extracorporeal membrane oxygenation (ECMO) allows partial or complete replacement of cardiac function and reduces the dose of inotropic drugs, improve oxygen delivery and thereby contribute to the rapid restoration of cardiac function.The purpose of this publication is to demonstrate in a clinical case the successful experience of ECMO in the treatment of a patient with septic myocarditis in the early postpartum period.Materials and methods. A 28-year-old patient, data from medical records at the previous stages of treatment and at the Sverdlovsk Regional Clinical Hospital No. 1.Results. On the third day of treatment, the patient’s condition worsened due to the progression of cardiovascular and respiratory failure. A veno-arterial ECMO procedure was initiated, which lasted 6 days.Discussion. Positive dynamics in the patient’s condition were observed during six days of ECMO (normalization of echocardiography parameters, levels of cardiac enzymes and natriuretic peptide).Conclusion. Veno-arterial ECMO as a temporary method of mechanical support of the left ventricle and prosthetic pulmonary function can be successfully used until their recovery in patients with septic myocarditis in the postpartum period.