Why the study?
Unstable pulmonary embolism with obstructive cardiac shock carries high maternal and fetal mortality, and the optimal strategy combining ECMO with clot-removal interventions remained unclear.
Does extracorporeal membrane oxygenation (ECMO) improve outcomes in pregnant patients with unstable pulmonary embolism?
Does extracorporeal membrane oxygenation (ECMO) improve outcomes in pregnant patients with unstable pulmonary embolism?
This study aims to assess the benefits and risks of ECMO in pregnant patients with pulmonary embolism to propose a new management algorithm.
Supports extracorporeal approaches in peripartum PE shock; leaves open optimal strategy pending prospective data.
The maternal and fetal mortality rate in unstable pulmonary embolisms accompanied by obstructive cardiac shock is approximately 30%. An intervention aimed at the pulmonary clot is essential under these conditions. There are various ways of removing this clot from the pulmonary arteries, including thrombolytic administration, percutaneous catheter-based thrombectomy, and direct surgical clot removal. These procedures all have advantages and disadvantages. Increasing use is being made of extracorporeal membrane oxygenation (ECMO) as a means of reducing these risks to a minimum. There are studies recommending ECMO together with thrombolysis or surgical thrombectomy. However, which study is superior to another is unclear. The purpose of the present study was, therefore, to assess the benefits and risks of ECMO use in pregnant patients with pulmonary embolism and to endeavor to produce a new algorithm.
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Ünver et al. (2020) studied this question.
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