Case #3
A 39 y/o Hispanic G7P4024 with PMH of obesity and asthma presented at
27w6d admitted with COVID-19 respiratory symptoms. Patient oxygen
requirement escalated quickly, and intubation was performed less than 48
hours after the presentation. On day five of mechanical ventilation
patient self-extubated and was re-intubated. On day seven, the patient
was proned for 16 hours due to worsening respiratory status (while less
evident on arterial blood gasses, the patient had intermittent
SpO2 drops to 80%, requiring temporary increases in
FiO2 to 100%). Upon supination, the P/F ratio dropped
from 258 to 155. However, no further proning was necessary as the
respiratory status improved (P/F ratio >200 at
FiO2 of 40-45%) (Figure S 2). Two days later, during a
sedation holiday, the patient again self-extubated. The resultant
prolonged acute hypoxia was complicated by fetal bradycardia and an
emergent bedside cesarean delivery at 29w2d. The patient was extubated
on postoperative day four and discharged home on day seven.