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BMC Pulmonary Medicine

Extracorporeal membrane oxygenation (ECMO) in patients with tuberculosis: systematic review and meta-analysis of 43 cases

  • Open Access
  • 01-12-2024
  • ECMO
  • Research
Published in:
Authors
Raja Idris
Ann-Sophie Zielbauer
Julia Koepsell
Jan Kloka
Nils Wetzstein
Published in
BMC Pulmonary Medicine | Issue 1/2024

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.
Title
Extracorporeal membrane oxygenation (ECMO) in patients with tuberculosis: systematic review and meta-analysis of 43 cases
Authors
Raja Idris
Ann-Sophie Zielbauer
Julia Koepsell
Jan Kloka
Nils Wetzstein
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-023-02715-x
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