PMID- 25166733
OWN - NLM
STAT- MEDLINE
DCOM- 20150602
LR  - 20220408
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 60
IP  - 5
DP  - 2014 Sep-Oct
TI  - The use of ECMO in HIV/AIDS with Pneumocystis jirovecii Pneumonia: a case report 
      and review of the literature.
PG  - 606-8
LID - 10.1097/MAT.0000000000000112 [doi]
AB  - There are few reports of extracorporeal membrane oxygenation (ECMO) therapy for 
      respiratory failure because of Pneumocystis jirovecii pneumonia (PJP) in patients 
      with acquired immunodeficiency syndrome (AIDS). None of the cases reported 
      involvement of immune reconstitution inflammatory syndrome (IRIS), a paradoxical 
      clinical worsening after the initiation of antiretroviral therapy (ART) in 
      ART-naive patients because of an exaggerated systemic inflammation with cell 
      count recovery. We present a patient with newly diagnosed AIDS and PJP pneumonia 
      that progressed to acute respiratory distress syndrome (ARDS) secondary to 
      probable IRIS for which veno-venous ECMO was initiated. He transitioned to 
      conventional ventilator after 57 days of ECMO therapy. However, he did not 
      survive to hospital discharge. Combined with four previously reported cases of 
      ARDS in human immunodeficiency virus patients secondary to PJP treated with ECMO, 
      three of the five patients survived to ECMO decannulation. Extracorporeal 
      membrane oxygenation is considered an accepted modality for adult patients with 
      respiratory and/or cardiac failure refractory to maximal medical therapy. As ECMO 
      becomes increasingly utilized in clinical practice, there is ongoing controversy 
      regarding the appropriate selection of patients. In the past, contraindications 
      to ECMO included immunocompromised states and conditions with known poor 
      prognosis. The cases herein suggest the indications and contraindications warrant 
      further discussion and research.
FAU - Cawcutt, Kelly
AU  - Cawcutt K
AD  - From the *Department of Medicine, Division of Pulmonary and Critical Care, Mayo 
      Clinic, Rochester, Minnesota; daggerDepartment of Medicine, Division of Infectious 
      Disease, Mayo Clinic, Rochester, Minnesota; and double daggerDepartment of Anesthesiology, 
      Mayo Clinic, Rochester, Minnesota.
FAU - Gallo De Moraes, Alice
AU  - Gallo De Moraes A
FAU - Lee, Sarah J
AU  - Lee SJ
FAU - Park, John G
AU  - Park JG
FAU - Schears, Gregory J
AU  - Schears GJ
FAU - Nemergut, Michael E
AU  - Nemergut ME
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Acquired Immunodeficiency Syndrome/*complications
MH  - *Extracorporeal Membrane Oxygenation
MH  - Fatal Outcome
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pneumocystis carinii
MH  - Pneumonia, Pneumocystis/*complications/physiopathology/*therapy
MH  - Respiratory Distress Syndrome/*complications/physiopathology
EDAT- 2014/08/29 06:00
MHDA- 2015/06/03 06:00
CRDT- 2014/08/29 06:00
PHST- 2014/08/29 06:00 [entrez]
PHST- 2014/08/29 06:00 [pubmed]
PHST- 2015/06/03 06:00 [medline]
AID - 00002480-201409000-00023 [pii]
AID - 10.1097/MAT.0000000000000112 [doi]
PST - ppublish
SO  - ASAIO J. 2014 Sep-Oct;60(5):606-8. doi: 10.1097/MAT.0000000000000112.