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[Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome caused by novel 2009 influenza A (H1N1) virus].
Zhonghua Yi Xue Za Zhi. 2011 Dec 13; 91(46):3262-6.ZY

Abstract

OBJECTIVE

To summarize the clinical experiences and indications of extracorporeal membrane oxygenation (ECMO) for severe ARDS caused by novel 2009 influenza A (H1N1) virus.

METHODS

All ECMO cases with severe ARDS associated with novel 2009 influenza A (H1N1) virus were analyzed in 5 intensive care units (ICUs) from 5 different hospitals in Beijing and Tianjin. A physician experienced in ECMO handling collected the relevant data, including general conditions pre and post-EMCO, efficacy and complication parameters, ventilator settings of mechanical ventilation and clinical outcomes. The statistical software of SPSS (version 11.5) was used for data analysis.

RESULTS

18 cases of novel H1N1 influenza with severe ARDS received ECMO. There were 9 males and 9 females (all pregnant). The mean age was (33 ± 11) years old. Eight were complicated with pulmonary barotraumas (6 of pneumothorax). Prior to ECMO, the patients underwent noninvasive and invasive positive pressure ventilation for 1 day and 60 hours respectively. Physiological parameters 2-6 hours prior to ECMO use were: (53 ± 14) mm Hg of PaO2/FiO2, (17 ± 5) cm H2O of positive end expiratory pressure (PEEP), 3.80 ± 0.29 of Murray lung injury score, (7.38 ± 0.10) of arterial pH, (3.3 ± 2.3) mmol/L of serum lactate, 16 ± 8 of APACHE II score. All patients treated venous-venous ECMO (VV-ECMO) for a mean duration of 8 days (range: 2 - 168). Settings of mechanical ventilation (prior to ECMO vs 2 hours post-ECMO) were: peak airway pressure (31 ± 7) vs (25 ± 6) cm H2O, respiratory rate (15 ± 4) vs (22 ± 6) breaths/min, FiO2 0.8 - 1.0 vs 0.35 - 0.50, PEEP (16 ± 5) vs (12 ± 4) cm H2O. Arterial blood gas (pH, PaO2 and PaCO2) post-ECMO of 2 hours and 24-hour significantly improved (P < 0.05). Seven patients died during ECMO, 11 patients were successfully weaned from ECMO. And 8 of them survived and were discharged. One patient stayed in ICU and 2 died in ICU.

CONCLUSIONS

As an effective measure of respiratory supports, ECMO may provide pulmonary rest and improve gas exchanges in severe ARDS induced by novel H1N1 Influenza.

Links

Publisher Full Text

Authors+Show Affiliations

Zhan QY
Department of Respiratory & Critical Care Medicine, Capital Medical University, Beijing, China.
Sun B
No affiliation info available
Tong ZH
No affiliation info available
Guo LM
No affiliation info available
Xu L
No affiliation info available
Zhu X
No affiliation info available
Jia XJ
No affiliation info available
Wang C
No affiliation info available

MeSH

AdultExtracorporeal Membrane OxygenationFemaleHumansInfluenza A Virus, H1N1 SubtypeInfluenza, HumanMaleMiddle AgedPregnancyRespiratory Distress SyndromeYoung Adult

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

chi

PubMed ID

22333146

Citation

Zhan, Qing-yuan, et al. "[Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome Caused By Novel 2009 Influenza a (H1N1) Virus]." Zhonghua Yi Xue Za Zhi, vol. 91, no. 46, 2011, pp. 3262-6.
Zhan QY, Sun B, Tong ZH, et al. [Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome caused by novel 2009 influenza A (H1N1) virus]. Zhonghua Yi Xue Za Zhi. 2011;91(46):3262-6.
Zhan, Q. Y., Sun, B., Tong, Z. H., Guo, L. M., Xu, L., Zhu, X., Jia, X. J., & Wang, C. (2011). [Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome caused by novel 2009 influenza A (H1N1) virus]. Zhonghua Yi Xue Za Zhi, 91(46), 3262-6.
Zhan QY, et al. [Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome Caused By Novel 2009 Influenza a (H1N1) Virus]. Zhonghua Yi Xue Za Zhi. 2011 Dec 13;91(46):3262-6. PubMed PMID: 22333146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome caused by novel 2009 influenza A (H1N1) virus]. AU - Zhan,Qing-yuan, AU - Sun,Bing, AU - Tong,Zhao-hui, AU - Guo,Li-min, AU - Xu,Lei, AU - Zhu,Xi, AU - Jia,Xiao-jun, AU - Wang,Chen, PY - 2012/2/16/entrez PY - 2012/2/16/pubmed PY - 2012/12/21/medline SP - 3262 EP - 6 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 91 IS - 46 N2 - OBJECTIVE: To summarize the clinical experiences and indications of extracorporeal membrane oxygenation (ECMO) for severe ARDS caused by novel 2009 influenza A (H1N1) virus. METHODS: All ECMO cases with severe ARDS associated with novel 2009 influenza A (H1N1) virus were analyzed in 5 intensive care units (ICUs) from 5 different hospitals in Beijing and Tianjin. A physician experienced in ECMO handling collected the relevant data, including general conditions pre and post-EMCO, efficacy and complication parameters, ventilator settings of mechanical ventilation and clinical outcomes. The statistical software of SPSS (version 11.5) was used for data analysis. RESULTS: 18 cases of novel H1N1 influenza with severe ARDS received ECMO. There were 9 males and 9 females (all pregnant). The mean age was (33 ± 11) years old. Eight were complicated with pulmonary barotraumas (6 of pneumothorax). Prior to ECMO, the patients underwent noninvasive and invasive positive pressure ventilation for 1 day and 60 hours respectively. Physiological parameters 2-6 hours prior to ECMO use were: (53 ± 14) mm Hg of PaO2/FiO2, (17 ± 5) cm H2O of positive end expiratory pressure (PEEP), 3.80 ± 0.29 of Murray lung injury score, (7.38 ± 0.10) of arterial pH, (3.3 ± 2.3) mmol/L of serum lactate, 16 ± 8 of APACHE II score. All patients treated venous-venous ECMO (VV-ECMO) for a mean duration of 8 days (range: 2 - 168). Settings of mechanical ventilation (prior to ECMO vs 2 hours post-ECMO) were: peak airway pressure (31 ± 7) vs (25 ± 6) cm H2O, respiratory rate (15 ± 4) vs (22 ± 6) breaths/min, FiO2 0.8 - 1.0 vs 0.35 - 0.50, PEEP (16 ± 5) vs (12 ± 4) cm H2O. Arterial blood gas (pH, PaO2 and PaCO2) post-ECMO of 2 hours and 24-hour significantly improved (P < 0.05). Seven patients died during ECMO, 11 patients were successfully weaned from ECMO. And 8 of them survived and were discharged. One patient stayed in ICU and 2 died in ICU. CONCLUSIONS: As an effective measure of respiratory supports, ECMO may provide pulmonary rest and improve gas exchanges in severe ARDS induced by novel H1N1 Influenza. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/22333146/[Extracorporeal_membrane_oxygenation_for_severe_acute_respiratory_distress_syndrome_caused_by_novel_2009_influenza_A__H1N1__virus]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2011&amp;vol=91&amp;issue=46&amp;fpage=3262 DB - PRIME DP - Unbound Medicine ER -