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

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 wer...

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Main Authors: Qinglin Wu, Fulan Cen, Guowei Wang, Jia Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2023.1264928/full
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author Qinglin Wu
Fulan Cen
Guowei Wang
Jia Huang
author_facet Qinglin Wu
Fulan Cen
Guowei Wang
Jia Huang
author_sort Qinglin Wu
collection DOAJ
description 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.
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spelling doaj.art-66429c81682642bca3fd7f6c4612f2732023-10-19T07:49:55ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-10-011010.3389/fmed.2023.12649281264928Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case reportQinglin WuFulan CenGuowei WangJia HuangIntroductionPatients 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.1264928/fullextracorporeal membrane oxygenation (ECMO)venovenous ECMO (VV-ECMO)acute respiratory distress syndrome (ARDS)pneumocystis jirovecii pneumonia (PJP)case report
spellingShingle Qinglin Wu
Fulan Cen
Guowei Wang
Jia Huang
Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
Frontiers in Medicine
extracorporeal membrane oxygenation (ECMO)
venovenous ECMO (VV-ECMO)
acute respiratory distress syndrome (ARDS)
pneumocystis jirovecii pneumonia (PJP)
case report
title Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
title_full Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
title_fullStr Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
title_full_unstemmed Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
title_short Early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome: a case report
title_sort early application of awake extracorporeal membrane oxygenation in pneumocystis jirovecii pneumonia complicated with severe acute respiratory distress syndrome a case report
topic extracorporeal membrane oxygenation (ECMO)
venovenous ECMO (VV-ECMO)
acute respiratory distress syndrome (ARDS)
pneumocystis jirovecii pneumonia (PJP)
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2023.1264928/full
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