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ARDS from miliary tuberculosis successfully treated with ECMO

Edda Vesteinsdottir1, Gunnar Myrdal2, Kristinn O Sverrisson1

  • 1Landspitali University Hospital, Department of Anaesthesia and Intensive Care, Hringbraut, 101, Reykjavik, Iceland.

Respiratory Medicine Case Reports
|January 22, 2019
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) can facilitate healing in severe acute respiratory distress syndrome (ARDS) caused by tuberculosis. This case demonstrates prolonged ECMO therapy is feasible for extensive lung damage, expanding its therapeutic applications.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Tuberculosis (TB) is an uncommon cause of acute respiratory distress syndrome (ARDS), associated with high mortality in mechanically ventilated patients.
  • Experience with extracorporeal membrane oxygenation (ECMO) for TB-induced ARDS is limited, highlighting a gap in clinical knowledge.

Observation:

  • A challenging case of miliary tuberculosis in an 18-year-old male presented with extensive lung damage requiring mechanical ventilation.
  • Diagnosis of tuberculosis was difficult, and achieving adequate anti-tuberculosis drug levels during ECMO posed significant challenges.

Findings:

  • Prolonged (50-day) extracorporeal membrane oxygenation (ECMO) therapy enabled the patient's extensive lung damage from miliary tuberculosis to heal.
  • Long-term ECMO treatment was successfully managed without severe complications, indicating its potential for extended use.

Implications:

  • This case expands the recognized indications for ECMO, showcasing its utility in complex respiratory failure scenarios.
  • The successful management underscores the possibility of long-term ECMO therapy, even in resource-intensive situations like severe tuberculosis.
  • It highlights the critical need for vigilance in diagnosing TB and optimizing drug delivery in patients undergoing ECMO.
Keywords:
Acute respiratory distress syndrome (ARDS)Antitubercular agentsCritical careExtracorporeal membrane oxygenation (ECMO)Tuberculosis

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