title: The successful treatment of refractory respiratory failure due to miliary tuberculosis: survival after prolonged extracorporeal membrane oxygenation support.
abstract: Acute respiratory distress syndrome (ARDS) has high morbidity and mortality. Although uncommon, pulmonary tuberculosis (TB) can cause ARDS in patients with extensive pulmonary parenchymal involvement. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an accepted alternative option in refractory hypoxemic respiratory failure. It may normalize gas exchange and allow lung rest, avoiding ventilator induced lung injury. We report the case of a 44-year-old woman who developed ARDS secondary to pulmonary TB. Despite anti-TB treatment and mechanical ventilation, patient had persistent refractory hypoxemia. In order to prevent further lung injury, VV-ECMO support was performed for 73 days. Although the patient experienced several complications, patient was successfully managed on VV-ECMO. VV-ECMO support, in combination with anti-TB drugs, is a useful tool in the treatment of ARDS with refractory hypoxemia caused by miliary TB.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Kosin University, Busan, Republic of Korea.
authors.forename: Sung-Jin
authors.initials: SJ
authors.lastname: Nam
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Cho
mesh_terms: D000328:Adult; D003422:Critical Care; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000382:microbiology / Q000628:therapy*; D016896:Treatment Outcome; D014391:Tuberculosis, Miliary / Q000150:complications*
keywords: extracorporeal membrane oxygenation; miliary; respiratory insufficiency; tuberculosis