Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series

Objective: To investigate the application effect of extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) caused by Pneumocystis jirovecii pneumonia (PJP) after kidney transplantation.Methods: This is a case series on 10 kidney transplant recip...

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Main Authors: Hong-Yu Wang, Yi-Hao Li, Si-Sen Zhang, Xin Jiang, Xing-Guo Niu, Xin-Ling Qian, Cong-Yan Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-06-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2022.902465/full
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author Hong-Yu Wang
Hong-Yu Wang
Hong-Yu Wang
Yi-Hao Li
Yi-Hao Li
Si-Sen Zhang
Si-Sen Zhang
Xin Jiang
Xing-Guo Niu
Xin-Ling Qian
Xin-Ling Qian
Cong-Yan Liu
Cong-Yan Liu
author_facet Hong-Yu Wang
Hong-Yu Wang
Hong-Yu Wang
Yi-Hao Li
Yi-Hao Li
Si-Sen Zhang
Si-Sen Zhang
Xin Jiang
Xing-Guo Niu
Xin-Ling Qian
Xin-Ling Qian
Cong-Yan Liu
Cong-Yan Liu
author_sort Hong-Yu Wang
collection DOAJ
description Objective: To investigate the application effect of extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) caused by Pneumocystis jirovecii pneumonia (PJP) after kidney transplantation.Methods: This is a case series on 10 kidney transplant recipients with severe ARDS caused by PJP at the People’s Hospital of Zhengzhou, who were enrolled as the case group. A total of 17 cases of PJP diagnosed with severe ARDS without ECMO were selected as the control group. The timing and mode of ECMO support and treatment complications were summarized. The primary aim of this study was mortality and secondary was imaging and complications.Results: The enrolled patients’ oxygenation index before the start of ECMO ranged from 25 to 92, and the time from admission to the start of ECMO was 1–17 days, with an average of 5.56 days. In the case group, one patient died of hemorrhagic shock due to abdominal hemorrhage, but the other nine patients were successfully weaned from ECMO. Of these patients, one died due to sepsis following weaning. The survival rate in the case group was 80.0% (8/10), and the survival rate in the control group was 35.29% (6/17). The vein–vein ECMO support time in the nine successfully weaned patients in the case group ranged from 131 to 288 h, with an average of 215.5 h. Of the eight patients who survived, deterioration of renal function after transplantation occurred in two patients, but no fatal complications occurred.Conclusion: Overall, Patients with severe ARDS caused by postoperative PJP infection following kidney transplantation have a poor prognosis. The mortality was lower in patients who were treated with ECMO compared to standard care.
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spelling doaj.art-9dd1db2b787e4b4b8105c3d15011c1502022-12-22T00:32:00ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-06-011310.3389/fphys.2022.902465902465Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case SeriesHong-Yu Wang0Hong-Yu Wang1Hong-Yu Wang2Yi-Hao Li3Yi-Hao Li4Si-Sen Zhang5Si-Sen Zhang6Xin Jiang7Xing-Guo Niu8Xin-Ling Qian9Xin-Ling Qian10Cong-Yan Liu11Cong-Yan Liu12Department of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaOrgan Transplant Department, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaDepartment of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaDepartment of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaOrgan Transplant Department, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaDepartment of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaDepartment of Emergency Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, ChinaDepartment of Emergency Intensive Care Unit, People’s Hospital of Henan University of Chinese Medicine/Zhengzhou People’s Hospital, Zhengzhou, ChinaObjective: To investigate the application effect of extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) caused by Pneumocystis jirovecii pneumonia (PJP) after kidney transplantation.Methods: This is a case series on 10 kidney transplant recipients with severe ARDS caused by PJP at the People’s Hospital of Zhengzhou, who were enrolled as the case group. A total of 17 cases of PJP diagnosed with severe ARDS without ECMO were selected as the control group. The timing and mode of ECMO support and treatment complications were summarized. The primary aim of this study was mortality and secondary was imaging and complications.Results: The enrolled patients’ oxygenation index before the start of ECMO ranged from 25 to 92, and the time from admission to the start of ECMO was 1–17 days, with an average of 5.56 days. In the case group, one patient died of hemorrhagic shock due to abdominal hemorrhage, but the other nine patients were successfully weaned from ECMO. Of these patients, one died due to sepsis following weaning. The survival rate in the case group was 80.0% (8/10), and the survival rate in the control group was 35.29% (6/17). The vein–vein ECMO support time in the nine successfully weaned patients in the case group ranged from 131 to 288 h, with an average of 215.5 h. Of the eight patients who survived, deterioration of renal function after transplantation occurred in two patients, but no fatal complications occurred.Conclusion: Overall, Patients with severe ARDS caused by postoperative PJP infection following kidney transplantation have a poor prognosis. The mortality was lower in patients who were treated with ECMO compared to standard care.https://www.frontiersin.org/articles/10.3389/fphys.2022.902465/fullextracorporeal membrane oxygenationkidney transplantationP. jirovecii pneumoniaacute respiratory distress syndromeapplication effect
spellingShingle Hong-Yu Wang
Hong-Yu Wang
Hong-Yu Wang
Yi-Hao Li
Yi-Hao Li
Si-Sen Zhang
Si-Sen Zhang
Xin Jiang
Xing-Guo Niu
Xin-Ling Qian
Xin-Ling Qian
Cong-Yan Liu
Cong-Yan Liu
Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
Frontiers in Physiology
extracorporeal membrane oxygenation
kidney transplantation
P. jirovecii pneumonia
acute respiratory distress syndrome
application effect
title Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
title_full Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
title_fullStr Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
title_full_unstemmed Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
title_short Application of Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Distress Syndrome Caused by Pneumocystis jirovecii Pneumonia Following Kidney Transplantation: A Case Series
title_sort application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome caused by pneumocystis jirovecii pneumonia following kidney transplantation a case series
topic extracorporeal membrane oxygenation
kidney transplantation
P. jirovecii pneumonia
acute respiratory distress syndrome
application effect
url https://www.frontiersin.org/articles/10.3389/fphys.2022.902465/full
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