Citations 1
Outcomes of Venovenous Extracorporeal Membrane Oxygenation for Pneumocystis jirovecii Pneumonia: A Multicenter Retrospective Case Series
Pulsipher, Aaron M. , Henry, Kyle, Cartin‐Ceba, Rodrigo , Lee, Augustine S. , Patel, B. M. , Miller, Brittany, Thompson, Emily , Sen, Ayan , Ham, Kealy R., Lee, Augustine, Thompson, Emily R , Pulsipher, Aaron M , Vikram, Holenarasipur R. , Gotway, Michael B. , Limper, Andrew H. , Miller, Brittany
Critical Care Explorations | August 4, 2025 | Volume: 7 | Issue: 8 | Pages: e1296
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening opportunistic infection increasingly recognized among non-HIV immunocompromised patients. In severe cases progressing to acute respiratory distress syndrome, venovenous extracorporeal membrane oxygenation (VV-ECMO) may serve as a rescue therapy. We conducted a retrospective multicenter review of 10 adult patients with proven or probable PCP who received VV-ECMO between 2017 and 2024. Seven of 10 patients survived to discharge, including all three HIV-positive patients and 4 of 7 non-HIV immunocompromised patients. The mean Respiratory ECMO Survival Prediction Score was –1.5, corresponding to a predicted survival of 33–57%. Multiorgan dysfunction was common, including renal failure requiring dialysis in 6 of 10 patients, need for neuromuscular blockade in 8 of 10, and pulmonary vasodilator use in 8 of 10. Despite high acuity and prolonged ECMO support, outcomes were favorable. These findings suggest that VV-ECMO may be a viable salvage therapy for select patients with severe PCP, including those without HIV.