Respiratory failure caused by tuberculous pneumonia requiring extracorporeal membrane oxygenation

Perfusion ◽  
2001 ◽  
Vol 16 (6) ◽  
pp. 525-529 ◽  
Author(s):  
Toni M Petrillo ◽  
Micheal L Heard ◽  
James D Fortenberry ◽  
Jana A Stockwell ◽  
Michael K Leonard
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Treatment Option ◽  
Antimicrobial Therapy ◽  
Ventilatory Support ◽  
Developed Countries ◽  
Membrane Oxygenation ◽  
Common Pathogen

While a common pathogen, Mycobacterium tuberculosis (TB) pneumonitis is only rarely reported as a cause for respiratory failure in developed countries. We report an adolescent with TB pneumonitis and respiratory failure requiring extracorporeal membrane oxygenation (ECMO) with eventual survival. With the incidence of TB rising globally, TB should be suspected and treated as early as possible. ECMO should be considered as a treatment option if conventional ventilatory support is inadequate. ECMO survival with TB pneumonia and anti-TB antimicrobial therapy is possible.

scholarly journals CRITICAL CARE ECHO ROUNDS: Extracorporeal membrane oxygenation

2015 ◽  
Vol 2 (2) ◽  
pp. D1-D11 ◽  
Author(s):  
Kelly Victor ◽  
Nicholas A Barrett ◽  
Stuart Gillon ◽  
Abigail Gowland ◽  
Christopher I S Meadows ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Ventilatory Support ◽  
Ecmo Support ◽  
Respiratory Physiology ◽  
Organ Support ◽  
Septic Cardiomyopathy ◽  
Significant Past Medical History ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Extracorporeal membrane oxygenation (ECMO) is an advanced form of organ support indicated in selected cases of severe cardiovascular and respiratory failure. Echocardiography is an invaluable diagnostic and monitoring tool in all aspects of ECMO support. The unique nature of ECMO, and its distinct effects upon cardio-respiratory physiology, requires the echocardiographer to have a sound understanding of the technology and its interaction with the patient. In this article, we introduce the key concepts underpinning commonly used modes of ECMO and discuss the role of echocardiography.CaseA 38-year-old lady, with no significant past medical history, was admitted to her local hospital with group A Streptococcal pneumonia. Rapidly progressive respiratory failure ensued and, despite intubation and maximal ventilatory support, adequate oxygenation proved impossible. She was attended by the regional severe respiratory failure service who established her on veno-venous (VV)-ECMO for respiratory support. Systemic oxygenation improved; however, significant cardiovascular compromise was encountered and echocardiography demonstrated a severe septic cardiomyopathy (ejection fraction <15%, aortic velocity time integral 5.9 cm and mitral regurgitation dP/dt 672 mmHg/s). Her ECMO support was consequently converted to a veno-veno-arterial configuration, thus providing additional haemodynamic support. As the sepsis resolved, arterial ECMO support was weaned under echocardiographic guidance; subsequent resolution of intrinsic respiratory function allowed the weaning of VV-ECMO support. The patient was liberated from ECMO 7 days after hospital admission.

scholarly journals CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure

2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Giles J Peek ◽  
Felicity Clemens ◽  
Diana Elbourne ◽  
Richard Firmin ◽  
Pollyanna Hardy ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Ventilatory Support ◽  
Membrane Oxygenation

Thrombosis of the Right Internal Jugular Vein is Not a Contraindication to Ambulatory Veno-Venous Extracorporeal Membrane Oxygenation with a Bicaval Dual-Lumen, Single Cannula System

2016 ◽  
Vol 19 (6) ◽  
pp. 282 ◽  
Author(s):  
Anthony Kronfli ◽  
Chetan Pasrija ◽  
Aakash Shah ◽  
Mehrdad Ghoreishi ◽  
Jose P Garcia ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Distress Syndrome ◽  
Ventilatory Support ◽  
Mechanical Ventilatory Support ◽  
Membrane Oxygenation ◽  
The Right ◽  
Hispanic Male ◽  
Cannula Placement ◽  
Vv Ecmo

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement. Case report: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS). Ambulatory VV-ECMO support was initiated, and during surgical cannula placement an occlusive thrombus was noted in the right IJ vein. A tract was dilated and the cannula was placed without any thromboembolic complications.Conclusion: This case demonstrates that cannulation for ambulatory VV-ECMO in the setting of an occlusive IJ thrombus can be safe and feasible.

Efficacy and Economic Assessment of Conventional Ventilatory Support versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure (CESAR)

2018 ◽  
pp. 135-140
Author(s):  
Matthew Sigakis
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Clinical Case ◽  
Ventilatory Support ◽  
Length Of Hospital Stay ◽  
Economic Assessment ◽  
High Volume ◽  
Severe Disability ◽  
Membrane Oxygenation ◽  
High Volume Center

The CESAR trial aimed to determine whether extracorporeal membrane oxygenation (ECMO) increased survival without disability by six months in patients with severe but potentially reversible respiratory failure. Patients were randomized to either conventional ventilator support or care at an ECMO referral center. The primary outcome measured was death or severe disability at 6 months. Secondary outcomes were also described such as non-ECMO support, length of stay, and ECMO characteristics. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The CESAR trial results indicate that patients with severe but potentially reversible respiratory failure have improved survival without severe disability when transferred to a high volume center with expertise in ECMO. Although survival without severe disability was improved, it was at a significantly increased cost and length of hospital stay. Concerns regarding the generalizability of the findings warrant further investigation.

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