Open AccessSevere acute respiratory distress syndrome in a patient with AIDS successfully treated with veno‐venous extracorporeal membrane oxygenation: a case report and literature review
Author(s) -
Obata Reiichiro,
Azuma Kazunari,
Nakamura Itaru,
Oda Jun
Publication year - 2018
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.364
Subject(s) - extracorporeal membrane oxygenation , medicine , pneumonia , acute respiratory distress , respiratory distress , refractory (planetary science) , respiratory failure , concomitant , intubation , intensive care medicine , pneumocystis pneumonia , surgery , anesthesia , lung , pneumocystis jirovecii , physics , astrobiology
Case Several successful uses of extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome in patients with novel HIV / AIDS infection have been reported; however, the therapeutic keys have not always been discussed. A 47‐year‐old man was admitted with progressive shortness of breath. He was in respiratory failure with a PaO 2 /F I O 2 ratio of 110.8 requiring intubation. Chest computed tomography showed diffuse ground glass opacities. An HIV infection was suspected, and a diagnosis of acute respiratory distress syndrome was made. Based on clinical indications, treatment for Pneumocystis jirovecii pneumonia and concomitant bacterial infection was started. Outcome Despite broad‐spectrum antibiotics, the patient's oxygenation deteriorated, necessitating ECMO. After 19 days of ECMO therapy, the patient was successfully decannulated and was eventually discharged. Conclusion In acute respiratory distress syndrome in patients with HIV / AIDS refractory to treatment, ECMO should be considered. Post‐ECMO antiretroviral therapy could improve outcomes.