Extra corporeal membrane oxygenation to facilitate lung protective ventilation and prevent ventilator-induced lung injury in severe Pneumocystis pneumonia with pneumomediastinum: a case report and short literature review

Table 3 Adult patients with HIV/AIDS and severe Pneumocystis jirovecii pneumonia requiring ECMO therapy

Patient (Ref)	Age (years)/Gender (M/F)	Pre-ECMO invasive ventilation (days)	Pneumothorax/Pneumomediastinum	Pre-ECMO P/F ratio; PaCO₂; pH	ECMO Configuration	Duration of ECMO (days)	CD4 count (cells/mm³)	HIV viral load (copies/mL)	Anti-Pneumocystis treatment	Timing of ART initiation	Outcome
Gutermann et al [10]	55/M	4	No	NR; NR; NR	Veno-arterial	4	9	80,235	TMP/SMX	Post-ECMO	Survived to hospital discharge
Steppan [11]	39/M	8	Yes	NR; NR; NR	Veno-venous	14	69	6297	CLI + PI, then ATQ, then TMP/SMX	Pre-ECMO	Died on ECMO
Goodman et al [12]	25/M	NR	No	63.6; 52.9; 7.38	Veno-venous	69	36	622,234	PI, then CLI + PQ, then TMP/SMX	Pre-ECMO	Died on ECMO
Goodman et al [12]	30/F	3	Yes	50.1; 41.6; 7.39	Veno-venous	7	13	976,631	TMP/SMX	Post-ECMO	Survived to hospital discharge
De Rosa et al [13]	21/F	NR	Yes	120; NR; NR	Veno-venous	20	2	118,330	TMP/SMX, then CLI + PQ	NR	Survived to hospital discharge
De Rosa et al [13]	24/M	NR	No	100; NR; NR	Veno-venous	24	3	50,728	TMP/SMX, then CLI + PQ + ATQ	During ECMO	Died in hospital post ECMO
Cawcutt et al [14]	45/M	NR	Yes	50; NR; NR	Veno-venous	57	33	113,000	TMP/SMX, CLI, PQ	Pre-ECMO	Died in hospital post ECMO
Our patient	26/M	1	Yes	200; 109; 7.01	Veno-venous	6	84	907,302	TMP/SMX	Post-ECMO	Survived to hospital discharge

P/F ratio Ratio of partial pressure arterial oxygen and fraction of inspired oxygen (mm Hg), PaCO ₂ Partial pressure of carbon dioxide in arterial blood (mm Hg), ART Antiretroviral therapy, TMP Trimethoprim, SMX Sulfamethoxazole, CLI Clindamycin, PI Pentamidine, ATQ Atovaquone, PQ Primaquine, NR Not reported

ISSN: 1471-2466