Extracorporeal membrane oxygenation for tuberculosis pneumonia with empyema

Santiago Besa; Álvaro J Morales; Patricio Salas; Sebastián Bravo M; Luis Garrido-Olivares

doi:10.1016/j.rmcr.2021.101481

Extracorporeal membrane oxygenation for tuberculosis pneumonia with empyema

Respir Med Case Rep. 2021:34:101481. doi: 10.1016/j.rmcr.2021.101481. Epub 2021 Jul 27.

Authors

Santiago Besa¹, Álvaro J Morales², Patricio Salas³, Sebastián Bravo M⁴, Luis Garrido-Olivares¹

Affiliations

¹ Department of Cardiovascular Surgery, Division of Surgery, Pontificia Universidad Católica, Santiago, Chile.
² Medical School, Pontificia Universidad Católica, Santiago, Chile.
³ Department of Thoracic Surgery, Division of Surgery, Pontificia Universidad Católica, Santiago, Chile.
⁴ Department of Intensive Medicine, Division of Internal Medicine, Pontificia Universidad Católica, Santiago, Chile.

Abstract

Acute respiratory distress syndrome (ARDS) caused by Mycobacterium Tuberculosis (TB) is a rare entity. Extracorporeal membrane oxygenation (ECMO) therapy had been used as an effective therapy for this cases, but the evidence is scarce. We present a case that took place in the middle of SARS-CoV2 pandemic. A 33-year-old female presented with ARDS due to pulmonary TB infection (pneumonia with empyema and pneumothorax), which required invasive mechanical ventilation with poor response. Long term veno-arterio-venous (VAV) ECMO, overlapped with veno-venous ECMO, was used as a salvage therapy with a good response for a total of 26 days. This is an example of the effectiveness of this therapy in this scenario, never described before. The fact that this therapy was used in the middle of SARS-CoV2 pandemic, with limited resources available, was remarkable, but it was encouraged by previous successful experiences.

Keywords: Acute respiratory failure; ECMO; Empyema; Tuberculosis.

Publication types

Case Reports