Successful use of extracorporeal membrane oxygenation in a human immunodeficiency virus infected patient with severe acute respiratory distress syndrome.
BACKGROUND
We report a case of an adult patient with human immunodeficiency virus (HIV), acute respiratory distress syndrome (ARDS) and ventilator associated pneumonia (VAP) caused by multidrug resistant (MDR) bacteria that was successfully managed with veno-venous extracorporeal membrane oxygenation (ECMO).


METHODS
A 25 year old male with no significant past medical history had been admitted to a local hospital due to dyspnea and fever. His pulmonary function subsequently failed necessitating mechanical ventilation (MV) and introduction of ECMO support. The patient was transported for 300 km by road on ECMO to a tertiary medical center. The diagnosis of ARDS, HIV infection and MDR bacterial and fungal VAP was made. Patient was successfully treated with antiretroviral therapy (ART), anti-infective agents and 58 days of veno-venous ECMO support, with complete resolution of the respiratory symptoms.


CONCLUSIONS
HIV infected patients with ARDS and MDR bacterial VAP whose HIV replication is controlled by ART could be successfully managed with ECMO.
Center of Anaesthesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Robertas
R
Samalavicius
Center of Anaesthesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ; Clinics of Anaesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Mindaugas
M
Serpytis
Center of Anaesthesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ; Clinics of Anaesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Donata
D
Ringaitiene
Center of Anaesthesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Daiva
D
Grazulyte
Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ; Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Ruta
R
Bertasiute
Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Bernardas
B
Rimkus
Department of Infectious, Chest diseases, Dermatovenerology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Center of Infectious Diseases, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Raimonda
R
Matulionyte
Center of Laboratory Medicine, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Ruta
R
Ambrazaitiene
Center of Anaesthesiology, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ; Clinics of Anaesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Jurate
J
Sipylaite
Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Tomas
T
Kacergius
Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ; Clinics of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Laimonas
L
Griskevicius
ARDS; HIV; VAP; multidrug resistant bacteria; veno-venous ECMO