Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report

Frontiers in Medicine

Medicine

Fulan Cen¹  Qinglin Wu¹  Guowei Wang¹  Jia Huang² 

[1] Department of Intensive Care Unit, Shenzhen Third People’s Hospital, Shenzhen, China;null;

关键词: extracorporeal membrane oxygenation (ECMO);    venovenous ECMO (VV-ECMO);    acute respiratory distress syndrome (ARDS);    pneumocystis jirovecii pneumonia (PJP);    case report;   

DOI  :  10.3389/fmed.2023.1264928

 received in 2023-07-21, accepted in 2023-09-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionPatients suffering from severe acute respiratory distress syndrome (ARDS) are usually treated with mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has traditionally been considered a life-saving therapy and was reserved as a last resort when other treatment options were exhausted. However, this report outlines our successful initial experience with early implementation of awake venovenous extracorporeal membrane oxygenation (VV-ECMO) in a case of pneumocystis jirovecii pneumonia complicated by severe acute respiratory distress syndrome (ARDS), offering a promising new approach for recovery.Case presentationWe present a case report of the effective application of awake VV-ECMO in a 29 years-old man with severe ARDS caused by pneumocystis jirovecii pneumonia. The patient initially received antibiotic treatment and non-invasive ventilation (NIV) for respiratory distress, but these interventions failed to improve the worsening dyspnea that occurred in the patient. Following the combined antifungal therapy, high-flow nasal cannula (HFNC) oxygen therapy, and VV-ECMO for a duration of 7 days, the patient’s symptoms improved, showing relief.ConclusionAwake VV-ECMO proved to be an effective treatment for critically ill patients with ARDS, avoiding the need for invasive mechanical ventilation. However, increased clinical evidence is needed to verify whether awake ECMO could be widely used in severe ARDS caused by other diseases or conditions.

【 授权许可】

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Copyright © 2023 Wu, Cen, Wang and Huang.