| Title: |
Extracorporeal membrane oxygenation for tuberculosis-related acute respiratory distress syndrome: An international multicentre retrospective cohort study |
| Authors: |
Ait Hssain A.; Petit M.; Wiest C.; Simon L.; Al-Fares A. A.; Hany A.; Garcia-Gomez D. I.; Besa S.; Nseir S.; Guervilly C.; Alqassem W.; Lesouhaitier M.; Chelaru A.; Sin S. W.; Roncon-Albuquerque R.; Giani M.; Lepper P. M.; Lavillegrand J. -R.; Park S.; Schellongowski P.; Fawzy Hassan I.; Combes A.; Sonneville R.; Schmidt M. |
| Contributors: |
Ait Hssain, A; Petit, M; Wiest, C; Simon, L; Al-Fares, A; Hany, A; Garcia-Gomez, D; Besa, S; Nseir, S; Guervilly, C; Alqassem, W; Lesouhaitier, M; Chelaru, A; Sin, S; Roncon-Albuquerque, R; Giani, M; Lepper, P; Lavillegrand, J; Park, S; Schellongowski, P; Fawzy Hassan, I; Combes, A; Sonneville, R; Schmidt, M |
| Publisher Information: |
Current Science Inc.; US |
| Publication Year: |
2024 |
| Collection: |
Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive) |
| Subject Terms: |
Acute respiratory distress syndrome; Extracorporeal membrane oxygenation; Miliary; Outcome; Tuberculosi |
| Description: |
OBJECTIVE: To 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. METHODS: An international multicenter retrospective study was conducted in 20 ECMO centers across 13 countries between 2002 and 2022. RESULTS: We 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 20days [10 to 34] and a median ICU stay of 42days [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. CONCLUSION: The 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. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/39385275; info:eu-repo/semantics/altIdentifier/wos/WOS:001337655300001; volume:28; issue:1; firstpage:332; journal:CRITICAL CARE; https://hdl.handle.net/10281/521239 |
| DOI: |
10.1186/s13054-024-05110-y |
| Availability: |
https://hdl.handle.net/10281/521239; https://doi.org/10.1186/s13054-024-05110-y |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative Commons ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.8B1E0840 |
| Database: |
BASE |