Successful treatment of severe electrolyte imbalance-induced cardiac arrest caused by adrenal tuberculosis with ECMO in the ED

Abstract

Background: Tuberculosis (TB) is a chronic infectious disease, common in China. TB bacteria can invade multiple organs throughout the body, but they rarely cause critical illness. We present a complex critically ill case in this report. Case presentation: A 40-year-old man suffered sudden cardiac arrest during an emergency room visit. Spontaneous circulation resumed after emergency cardiopulmonary resuscitation (CPR), but recurrent ventricular fibrillation and refractory cardiac shock emerged. Thereafter, extracorporeal membrane oxygenation (ECMO) was implemented to maintain hemodynamic stability. Blood test results revealed that the patient had severe electrolyte imbalance and adrenal insufficiency. Further imaging examination showed multiple tuberculosis lesions throughout the body, including the lungs, adrenal glands, and lumbar spine. In the end, the patient was successfully moved from the ICU after weaning from ECMO and the ventilator, and then transferred to an infectious disease specialist hospital for standard anti-tuberculosis therapy. Conclusions: ECMO has won the opportunity for the diagnosis and treatment of this young patient who suffered from a rare cause of cardiac arrest and finally achieved a good prognosis.