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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219870
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)
  • CASE REPORT

Successful repeat ECMO in a patient with AIDS and ARDS

Open Access
  1. Alan Kawarai Lefor2
  1. 1Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Saitama, Japan
  2. 2Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
  1. Correspondence to Professor Masamitsu Sanui, msanui{at}mac.com
  • Accepted 9 June 2017
  • Published 28 June 2017

Summary

Veno-venous extracorporeal membrane oxygenation (ECMO) is being more commonly used in patients with acute respiratory distress syndrome (ARDS) due to potentially reversible illnesses. Survival from ARDS using ECMO has been reported even in patients with AIDS. However, the indications for ECMO for ARDS due to immune reconstitution inflammatory syndrome (IRIS) in patients with AIDS are unknown. A 23-year-old man with AIDS and Pneumocystis jirovecii pneumonia was admitted to the intensive care unit with severe ARDS refractory to mechanical ventilator support requiring ECMO. Although ECMO was discontinued, a second treatment with ECMO was necessary due to IRIS-associated ARDS, resulting in an excellent patient outcome. This patient’s clinical course suggests two important messages. First, ECMO is a reasonable option for the treatment of patients with ARDS even in a patient with AIDS. Second, ECMO may be effective for the treatment of patients with IRIS.

Footnotes

  • Contributors SH, MS and YF contributed to the conception of the case report, acquisition of patient information, analysis and interpretation of the data. SH, MS and AKL drafted the article and revised it critically for important intellectual content. MS contributed to the care of the patient. All the authors made final approval of the version published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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