ECMO support may be associated with improved survival in tuberculosis associated severe ARDS

Area of Science:

• Critical Care Medicine
• Respiratory Medicine
• Infectious Diseases

Background:

• Limited data exists on Extracorporeal Membrane Oxygenation (ECMO) for Tuberculosis (Tbc)-associated Acute Respiratory Distress Syndrome (ARDS).
• Existing literature primarily consists of isolated case reports.

Purpose of the Study:

• To analyze intensive care unit (ICU) survival in patients with Tbc-associated ARDS.
• To compare survival rates between patients receiving veno-venous (vv-) ECMO and those receiving standard care.

Main Methods:

• Retrospective analysis of 14 patients with Tbc-associated ARDS across three ECMO-referral university hospitals.
• Eight patients received vv-ECMO support, while six received standard care.
• ICU survival and mortality rates were compared between the two groups.

Main Results:

• ICU survival was significantly higher in the vv-ECMO group (62.5%) compared to the standard care group (16.7%) (p=0.021).
• ECMO support was associated with reduced ICU mortality (adj. HR 0.125, p=0.017).
• Median ECMO and ventilation times were 20 and 37 days, respectively; major bleeding occurred in one patient, and no thromboembolic events were reported.

Conclusions:

• Veno-venous ECMO is a feasible approach for severe Tbc-associated ARDS.
• Despite extended support durations, vv-ECMO may improve survival in these patients.
• Consideration of vv-ECMO is recommended for Tbc-associated ARDS to facilitate lung-protective strategies and prolonged recovery.