Acute respiratory distress syndrome (ARDS) has high morbidity and mortality. Although uncommon, pulmonary tuberculosis (TB) can cause ARDS in patients with extensive pulmonary parenchymal involvement. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an accepted alternative option in refractory hypoxemic respiratory failure. It may normalize gas exchange and allow lung rest, avoiding ventilator induced lung injury. We report the case of a 44-year-old woman who developed ARDS secondary to pulmonary TB. Despite anti-TB treatment and mechanical ventilation, patient had persistent refractory hypoxemia. In order to prevent further lung injury, VV-ECMO support was performed for 73 days. Although the patient experienced several complications, patient was successfully managed on VV-ECMO. VV-ECMO support, in combination with anti-TB drugs, is a useful tool in the treatment of ARDS with refractory hypoxemia caused by miliary TB.
Keywords: extracorporeal membrane oxygenation; miliary; respiratory insufficiency; tuberculosis.
© 2016 John Wiley & Sons Ltd.