TY - JOUR
T1 - Extracorporeal membrane oxygenation in acute respiratory distress syndrome due to influenza A (H1N1)pdm09 pneumonia. A single-center experience during the 2013-2014 season
AU - Menon, Nithya
AU - Perez-Velez, Carlos M.
AU - Wheeler, Jennifer A.
AU - Morris, Michael F.
AU - Amabile, Orazio L.
AU - Tasset, Mark R.
AU - Raschke, Robert A.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective: This report aimed to describe the outcomes of the patients with severe H1N1 associated acute respiratory distress syndrome who were treated with extracorporeal membrane oxygenation therapy. Methods: This retrospective review analyzed a single-center cohort of adult patients with H1N1-related acute respiratory distress syndrome who were managed with veno-venous extracorporeal membrane oxygenation during the winter of 2013/2014. Results: A total of 10 patients received veno-venous extracorporeal membrane oxygenation for H1N1 influenza between January 2013 and March 2014. Seven patients were transferred to our center for extracorporeal membrane oxygenation consideration (all within 72 hours of initiating mechanical ventilation). The median patient age was forty years, and 30% were female. The median arterial oxygen partial pressure to fraction of inspired oxygen ratio was 62.5, and the median RESP score was 6. Three patients received inhaled nitric oxide, and four patients were proned as rescue therapy before extracorporeal membrane oxygenation was initiated. The median duration of mechanical ventilation was twenty-Two days (range, 14-32). The median length of stay in the intensive care unit was twenty-seven days (range, 14-39). The median hospital length of stay was 29.1 days (range, 16.0-46.9). Minor bleeding complications occurred in 6 of 10 patients. Eight of the ten patients survived to hospital discharge. Conclusion: The survivors were relatively young and discharged with good functional status (i.e., enhancing quality-Adjusted life-years-saved). Our experience shows that even a relatively new extracorporeal membrane oxygenation program can play an important role in that capacity and provide excellent outcomes for the sickest patients.
AB - Objective: This report aimed to describe the outcomes of the patients with severe H1N1 associated acute respiratory distress syndrome who were treated with extracorporeal membrane oxygenation therapy. Methods: This retrospective review analyzed a single-center cohort of adult patients with H1N1-related acute respiratory distress syndrome who were managed with veno-venous extracorporeal membrane oxygenation during the winter of 2013/2014. Results: A total of 10 patients received veno-venous extracorporeal membrane oxygenation for H1N1 influenza between January 2013 and March 2014. Seven patients were transferred to our center for extracorporeal membrane oxygenation consideration (all within 72 hours of initiating mechanical ventilation). The median patient age was forty years, and 30% were female. The median arterial oxygen partial pressure to fraction of inspired oxygen ratio was 62.5, and the median RESP score was 6. Three patients received inhaled nitric oxide, and four patients were proned as rescue therapy before extracorporeal membrane oxygenation was initiated. The median duration of mechanical ventilation was twenty-Two days (range, 14-32). The median length of stay in the intensive care unit was twenty-seven days (range, 14-39). The median hospital length of stay was 29.1 days (range, 16.0-46.9). Minor bleeding complications occurred in 6 of 10 patients. Eight of the ten patients survived to hospital discharge. Conclusion: The survivors were relatively young and discharged with good functional status (i.e., enhancing quality-Adjusted life-years-saved). Our experience shows that even a relatively new extracorporeal membrane oxygenation program can play an important role in that capacity and provide excellent outcomes for the sickest patients.
KW - Acute
KW - Extracorporeal membrane oxygenation
KW - H1N1 subtype
KW - Influenza A virus
KW - Respiratory distress syndrome
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U2 - 10.5935/0103-507X.20170048
DO - 10.5935/0103-507X.20170048
M3 - Review article
C2 - 28977101
AN - SCOPUS:85030686086
SN - 0103-507X
VL - 29
SP - 271
EP - 278
JO - Revista Brasileira de Terapia Intensiva
JF - Revista Brasileira de Terapia Intensiva
IS - 3
ER -