Hssain, Ali Ait and Petit, Matthieu and Wiest, Clemens and Simon, Laura and Al-Fares, Abdulrahman A. and Hany, Ahmed and Garcia-Gomez, Dafna I. and Besa, Santiago and Nseir, Saad and Guervilly, Christophe and Alqassem, Wael and Lesouhaitier, Mathieu and Chelaru, Adrian and Sin, Simon W. C. and Roncon-Albuquerque Jr, Roberto and Giani, Marco and Lepper, Philipp M. and Lavillegrand, Jean-Remi and Park, Sunghoon and Schellongowski, Peter and Hassan, Ibrahim Fawzy and Combes, Alain and Sonneville, Romain and Schmidt, Matthieu (2024) Extracorporeal membrane oxygenation for tuberculosis-related acute respiratory distress syndrome: An international multicentre retrospective cohort study. CRITICAL CARE, 28 (1): 332. ISSN 1364-8535, 1466-609X
Full text not available from this repository. (Request a copy)Abstract
ObjectiveTo report the outcomes of patients with severe tuberculosis (TB)-related acute respiratory distress syndrome (ARDS) on extracorporeal membrane oxygenation (ECMO), including predictors of 90-day mortality and associated complications.MethodsAn international multicenter retrospective study was conducted in 20 ECMO centers across 13 countries between 2002 and 2022.ResultsWe collected demographic data, clinical details, ECMO-related complications, and 90-day survival status for 79 patients (median APACHE II score of 20 [25th to 75th percentile, 16 to 28], median age 39 [28 to 48] years, PaO2/FiO2 ratio of 69 [55 to 82] mmHg before ECMO) who met the inclusion criteria. Thoracic computed tomography showed that 61 patients (77%) had cavitary TB, while 18 patients (23%) had miliary TB. ECMO-related complications included major bleeding (23%), ventilator-associated pneumonia (41%), and bloodstream infections (32%). The overall 90-day survival rate was 51%, with a median ECMO duration of 20 days [10 to 34] and a median ICU stay of 42 days [24 to 65]. Among patients on VV ECMO, those with miliary TB had a higher 90-day survival rate than those with cavitary TB (90-day survival rates of 81% vs. 46%, respectively; log-rank P = 0.02). Multivariable analyses identified older age, drug-resistant TB, and pre-ECMO SOFA scores as independent predictors of 90-day mortality.ConclusionThe use of ECMO for TB-related ARDS appears to be justifiable. Patients with miliary TB have a much better prognosis compared to those with cavitary TB on VV ECMO.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FAILURE; PATIENT; ORGANIZATION; SCORE; Extracorporeal membrane oxygenation; Acute respiratory distress syndrome; Tuberculosis; Miliary; Outcome |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Aug 2025 05:53 |
| Last Modified: | 06 Aug 2025 05:53 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65698 |
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