Kasuistik: ECMO-Einsatz bei hyperkapnischer Hirndruckkrise

Zusammenfassung

Unter der Geburt trübte sich bei einer 29-jährigen Patientin die Vigilanz progredient bis zum Koma. Grund war eine schwere Hirnblutung als Komplikation eines bis dahin nicht erkennbaren HELLP-Syndroms. Nach der zerebralen OP entwickelte die Patientin aggravierend ein schweres ARDS mit Hyperkapnie und kritischem Anstieg des intrakraniellen Druckes. Trotz Kontraindikation war eine ECMO-Therapie für insgesamt 31 Tage letztlich erfolgreich.

Abstract

We report a case of a 29-year-old primigravida asian woman with severe peripartal HELLP-syndrome. During delivery she developed coma. HELLP syndrome, complicated by severe intracerebral hemorrhage was detected. During course of therapy with drainage of intraventricular intracerebral hemorrhage, the patient developed pneumonia followed by severe acute respiratory distress syndrome (ARDS) with critically raised ICP. After 31 days of stabilization by extracorporeal membrane oxygenation (ECMO) and lung protective ventilation the patient was weaned of ECMO therapy. Following a period of 107 days including the weaning of respirator-therapy her neurologic status improved and she was able to follow commands, move upper and lower extremities on request, and recognize her relatives.

Schlüsselwörter

zerebraler Blutfluss - intrakranieller Druck (ICP) - ECMO - ARDS - HELLP-Syndrom

Key words

cerebral blood flow - intracranial pressure (ICP) - ECMO - ARDS - HELLP-syndrome

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