Browsing by Author "Trikannad Ashwini Kumar, Anup Kumar"

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    Critical Care Management of a Severe Acute Respiratory Distress Syndrome COVID-19 Patient With Control Cesarean Section
    (Cureus, 2022-02-27) Chang, Eduardo E.; Cordoba, Marcos; Vellanki, Sruthi; Trikannad Ashwini Kumar, Anup Kumar; Segura, Esther; Medicine, School of Medicine
    We share our experience of one 29-year-old female, G2 P1, with acute respiratory distress syndrome (ARDS) and at 30 weeks of pregnancy. The 30-week gravid uterus in combination with a poor ventilation-perfusion ratio creates a restrictive lung pattern that may prove to be lethal for both the mother and baby. Due to her rapid deterioration and increased hemodynamic instability we opted for controlled delivery in the operating room with an ICU physician, a Neonatologist, and an Obstetric team. At 3.27 minutes from induction, the baby was born with Apgar scores of 7 and 8. The mother was placed on a RotoProne® bed, treated with remdesivir, steroids, and was subsequently extubated seven days later. The newborn was admitted to the Neonatal Intensive Care Unit (NICU) after delivery. We have reviewed the literature and provided a concise set of recommendations based on our field experience and current world literature review. Prompt delivery in a controlled environment with multiple resuscitating teams provided expeditious treatment of both patients, maintaining oxygenation and perfusion while keeping hemodynamic stability. The controlled environment and the proximity of all teams avoided deleterious consequences to the unborn baby. This is an example where the risk of keeping the baby in the womb outweighs the premature delivery into a NICU. Both mother and baby were downgraded from their respective Intensive Care Units (ICUs) and discharged home in one month.
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    Rare Thrombotic Complications of COVID-19: A Case Series
    (Cureus, 2022-02-26) Vellanki, Sruthi; Trikannad Ashwini Kumar, Anup Kumar; Stoffel, Ryan; Vellanki, Sravya; Nuffer, Zachary; Medicine, School of Medicine
    Coronavirus disease 2019 (COVID-19) is known to manifest with bilateral pneumonia and acute respiratory distress syndrome. This infection with severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) is alarming because it not only affects the respiratory system but may also cause thromboembolic events. Multiple studies have reported procoagulation/hypercoagulable complications in COVID-19. This case series is a valuable addition to the literature because it reflects unique presentations of thrombotic events in COVID-19 patients. We report two cases in which patients presented with thromboembolic complications secondary to COVID-19 infection: one with severe bowel ischemia and the other with blue toe syndrome. To formulate management strategies to prevent fatal outcomes for patients with COVID-19, physicians must be vigilant in identifying life-threatening thromboembolic complications from this disease.