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体外膜肺氧合在急性呼吸窘迫综合征合并肺结核治疗中的新作用:一例病例报告及文献综述

A new role of extracorporeal membrane oxygenation in the management of tuberculosis with acute respiratory distress syndrome: A case report and review of literature.

作者信息

Anand Shweta, Singla Rupak, Kumar Vikas, Dewan Sandeep, Faye Abhishek, Gupta Amitesh

机构信息

Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.

Department of Critical Care Medicine, Fortis Memorial Research Institute, Gurugram, Haryana, India.

出版信息

Lung India. 2022 Jan-Feb;39(1):77-79. doi: 10.4103/lungindia.lungindia_173_21.

Abstract

Pulmonary tuberculosis (PTB) can lead to acute respiratory distress syndrome (ARDS), which can be at times fatal. Venovenous extracorporeal membrane oxygenation (VV-ECMO) ensures adequate oxygenation and carbon dioxide removal, avoiding ventilator-induced lung injury. We present a case where a young woman with refractory respiratory failure caused by PTB, unresponsive to conventional mechanical ventilation, but was successfully managed with prolonged VV-ECMO support. The patient diagnosed with PTB was started on antitubercular treatment but went into respiratory failure and ARDS. The patient was put on mechanical ventilation, on which she was not improving. The patient was then put on ECMO. On the 9 day, lung compliance and gas exchange were good enough to resume conventional mechanical ventilation. ECMO was weaned and removed. This is one of few cases of survival of the patient with PTB with ARDS utilizing ECMO.

摘要

肺结核(PTB)可导致急性呼吸窘迫综合征(ARDS),有时可能致命。静脉-静脉体外膜肺氧合(VV-ECMO)可确保充足的氧合和二氧化碳清除,避免呼吸机诱导的肺损伤。我们报告一例年轻女性病例,该患者因PTB导致难治性呼吸衰竭,对传统机械通气无反应,但通过延长VV-ECMO支持成功得到救治。该患者被诊断为PTB并开始抗结核治疗,但随后出现呼吸衰竭和ARDS。患者接受机械通气,但病情无改善。随后患者接受ECMO治疗。在第9天,肺顺应性和气体交换足够好,得以恢复传统机械通气。ECMO逐渐撤机并移除。这是利用ECMO治疗PTB合并ARDS患者存活的少数病例之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7669/8926221/bcbed7b023bf/LI-39-77-g001.jpg

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