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Extracorporeal membrane oxygenation for critically ill patients with 2009 influenza A (H1N1)-related acute respiratory distress syndrome: preliminary experience from a single center.
Artif Organs. 2012 Sep; 36(9):780-6.AO

Abstract

From early May 2009, the novel influenza A (H1N1) pandemic affected mainland China. Of those infected, a small proportion of patients developed acute respiratory distress syndrome (ARDS) so rapidly and severely that conventional ventilation treatment was ineffective. As an alternative treatment, the effect of extracorporeal membrane oxygenation (ECMO) was evaluated. From November 2009 to January 2010, all patients suffering from influenza A (H1N1)-associated ARDS referred to Beijing Anzhen Hospital for treatment with ECMO were enrolled. We describe the characteristics, treatment, and outcomes of these patients at 1- and 3-month follow-up. Nine patients (four females; mean age, 31.2 [21-59] years) from four centers were enrolled. All females had a history of recent pregnancy or had recently given birth. Before ECMO, patients had severe respiratory failure despite advanced mechanical ventilatory support with a mean partial pressure of arterial oxygen/fraction of inspired oxygen of 52.9 ± 5.1 (45.0-63.8) mm Hg, positive end-expiratory pressure of 17.2 ± 4.2 cmH(2) O, and a Murray Lung Score of 3.6 (3.25-3.75). All nine patients were treated with veno-venous ECMO via percutaneous access. The mean duration of ECMO support was 436.6 ± 652.1 h (67.0-2160.0). At the end of 1-year follow-up, five patients (55.7%) were weaned from ECMO. Five patients (55.7%) survived to hospital discharge. Four patients (44.4%) died while undergoing ECMO. The mean length of intensive care unit and hospital stay was 4-204 days (median, 32) and 4-234 days (median, 38), respectively. There was no significant difference between survivors and nonsurvivors in the screened parameters. Use of ECMO for critically ill patients with 2009 influenza A (H1N1)-related ARDS is feasible and effective. However, this treatment is technically demanding. For success, careful selection of patients is crucial.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Hou X
Department of Extracorporeal Circulation, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. houxiaotong@yahoo.com.cn
Guo L
No affiliation info available
Zhan Q
No affiliation info available
Jia X
No affiliation info available
Mi Y
No affiliation info available
Li B
No affiliation info available
Sun B
No affiliation info available
Hao X
No affiliation info available
Li H
No affiliation info available

MeSH

AdultChinaCritical IllnessExtracorporeal Membrane OxygenationFemaleFollow-Up StudiesHumansInfluenza A Virus, H1N1 SubtypeInfluenza, HumanMaleMiddle AgedPregnancyRespiratory Distress SyndromeTreatment OutcomeYoung Adult

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22747918

Citation

Hou, Xiaotong, et al. "Extracorporeal Membrane Oxygenation for Critically Ill Patients With 2009 Influenza a (H1N1)-related Acute Respiratory Distress Syndrome: Preliminary Experience From a Single Center." Artificial Organs, vol. 36, no. 9, 2012, pp. 780-6.
Hou X, Guo L, Zhan Q, et al. Extracorporeal membrane oxygenation for critically ill patients with 2009 influenza A (H1N1)-related acute respiratory distress syndrome: preliminary experience from a single center. Artif Organs. 2012;36(9):780-6.
Hou, X., Guo, L., Zhan, Q., Jia, X., Mi, Y., Li, B., Sun, B., Hao, X., & Li, H. (2012). Extracorporeal membrane oxygenation for critically ill patients with 2009 influenza A (H1N1)-related acute respiratory distress syndrome: preliminary experience from a single center. Artificial Organs, 36(9), 780-6. https://doi.org/10.1111/j.1525-1594.2012.01468.x
Hou X, et al. Extracorporeal Membrane Oxygenation for Critically Ill Patients With 2009 Influenza a (H1N1)-related Acute Respiratory Distress Syndrome: Preliminary Experience From a Single Center. Artif Organs. 2012;36(9):780-6. PubMed PMID: 22747918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extracorporeal membrane oxygenation for critically ill patients with 2009 influenza A (H1N1)-related acute respiratory distress syndrome: preliminary experience from a single center. AU - Hou,Xiaotong, AU - Guo,Limin, AU - Zhan,Qingyuan, AU - Jia,Xiaojun, AU - Mi,Yuhong, AU - Li,Baoshun, AU - Sun,Bin, AU - Hao,Xing, AU - Li,Hui, Y1 - 2012/07/02/ PY - 2012/7/4/entrez PY - 2012/7/4/pubmed PY - 2013/1/26/medline SP - 780 EP - 6 JF - Artificial organs JO - Artif Organs VL - 36 IS - 9 N2 - From early May 2009, the novel influenza A (H1N1) pandemic affected mainland China. Of those infected, a small proportion of patients developed acute respiratory distress syndrome (ARDS) so rapidly and severely that conventional ventilation treatment was ineffective. As an alternative treatment, the effect of extracorporeal membrane oxygenation (ECMO) was evaluated. From November 2009 to January 2010, all patients suffering from influenza A (H1N1)-associated ARDS referred to Beijing Anzhen Hospital for treatment with ECMO were enrolled. We describe the characteristics, treatment, and outcomes of these patients at 1- and 3-month follow-up. Nine patients (four females; mean age, 31.2 [21-59] years) from four centers were enrolled. All females had a history of recent pregnancy or had recently given birth. Before ECMO, patients had severe respiratory failure despite advanced mechanical ventilatory support with a mean partial pressure of arterial oxygen/fraction of inspired oxygen of 52.9 ± 5.1 (45.0-63.8) mm Hg, positive end-expiratory pressure of 17.2 ± 4.2 cmH(2) O, and a Murray Lung Score of 3.6 (3.25-3.75). All nine patients were treated with veno-venous ECMO via percutaneous access. The mean duration of ECMO support was 436.6 ± 652.1 h (67.0-2160.0). At the end of 1-year follow-up, five patients (55.7%) were weaned from ECMO. Five patients (55.7%) survived to hospital discharge. Four patients (44.4%) died while undergoing ECMO. The mean length of intensive care unit and hospital stay was 4-204 days (median, 32) and 4-234 days (median, 38), respectively. There was no significant difference between survivors and nonsurvivors in the screened parameters. Use of ECMO for critically ill patients with 2009 influenza A (H1N1)-related ARDS is feasible and effective. However, this treatment is technically demanding. For success, careful selection of patients is crucial. SN - 1525-1594 UR - https://www.unboundmedicine.com/medline/citation/22747918/Extracorporeal_membrane_oxygenation_for_critically_ill_patients_with_2009_influenza_A__H1N1__related_acute_respiratory_distress_syndrome:_preliminary_experience_from_a_single_center_ DB - PRIME DP - Unbound Medicine ER -