Idris R, Zielbauer AS, Koepsell J, Kloka J, Wetzstein N. Extracorporeal membrane oxygenation (ECMO) in patients with tuberculosis: systematic review and meta-analysis of 43 cases.
BMC Pulm Med 2024;
24:47. [PMID:
38254072 PMCID:
PMC10801979 DOI:
10.1186/s12890-023-02715-x]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/15/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION
Tuberculosis (TB) is still a major contributor to the global health burden. Pulmonary TB can lead to life-threatening respiratory failure necessitating extracorporeal membrane oxygenation (ECMO) therapy. However, data on ECMO experience in the management of TB patients are scarce.
METHODS
We conducted a systematic review of the literature using the search terms ECMO, extracorporeal membrane oxygenation, TB and tuberculosis in three databases (Medline, Web of Science and EMBASE). Clinical data were extracted by two independent investigators. Clinical parameters, such as mode of ECMO therapy, duration of treatment and clinical outcomes, were assessed.
RESULTS
Overall, 43 patients from 15 countries were included in the analysis. The age ranged from 0 to 65 years, 39.5% were male, and 60.5% were female. The majority of patients suffered from ARDS (83.4%), with a mean Horovitz quotient of 68.1 (range 30.0-131.0). 83.7% received VV-ECMO, and 24.3% received VA-ECMO. Coinfections and complications were frequently observed (45.5% and 48.6% respectively). At the end of the respective observation period, the overall outcome was excellent, with 81.4% survival.
DISCUSSION
ECMO therapy in TB patients appears to be a feasible therapeutic option, providing a bridge until antimycobacterial therapy takes effect. As the underlying cause is reversible, we advocate for the evaluation of ECMO usage in these patients with acute cardiac or respiratory failure.
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