Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome

Abstract

Context The novel influenza A(H1N1) pandemic affected Australia and New Zealand during the 2009 southern hemisphere winter. It caused an epidemic of critical illness and some patients developed severe acute respiratory distress syndrome (ARDS) and were treated with extracorporeal membrane oxygenation (ECMO). Objectives To describe the characteristics of all patients with 2009 influenza A(H1N1)associated ARDS treated with ECMO and to report incidence, resource utilization, and patient outcomes. Design, Setting, and Patients An observational study of all patients (n=68) with 2009 influenza A(H1N1)-associated ARDS treated with ECMO in 15 intensive care units (ICUs) in Australia and New Zealand between June 1 and August 31, 2009. Main Outcome Measures Incidence, clinical features, degree of pulmonary dysfunction, technical characteristics, duration of ECMO, complications, and survival.

Extracorporeal Membrane Oxygenation in Adults

“…It was only in 2009 that the publication of the results of the CESAR study (Conventional ventilatory support versus ECMO for Severe Adult Respiratory failure) as well as treatment results during the H1N1 viral pneumonia epidemic in Australia and New Zealand once again sparked interest for the application of ECMO in adult patients. This multicentric study demonstrated better survival and lower disability after six months in patients with ARDS referred to an ECMO center in comparison with the conventional approach 5, 47 . In the meantime, the majority of mostly observational and controlled studies also showed better outcomes in patients with respiratory insufficiency treated with ECMO in comparison with conventional treatment 31,35,36,48-55 .…”

“…Tek 2009. godine objavljivanje rezulata studije CE-SAR (Conventional ventilatory support versus ECMO for Severe Adult Respiratory failure), kao i rezultati liječenja tijekom pandemije H1N1 virusne upale pluća u Australiji i na Novom Zelandu, ponovno su potaknuli interes za primjenu ECMO-a u odraslih bolesnika. Navedena multricentrična studija pokazala je bolje preživljenje i manju onesposobljenost nakon šest mjeseci u bolesnika s ARDS-om upućenih u ECMO centar u usporedbi s konvencionalnim pristupom 5, 47 . Do danas veći broj pretežno opservacijskih i kontroliranih studija također pokazuje bolje ishode u bolesnika s respiracijskom insuficijencijom liječenih ECMO-om nego u konvencionalno liječe-nih 31,35,36,48-55 .…”

Influenza: One Health in action

“…[16][17][18] Advances in diagnostic laboratory techniques meant that diagnoses and characterisation of the pandemic (H1N1) 2009 influenza virus, including antiviral drug resistance, was rapid. [19][20][21] With most respiratory tract viral infections there is more mild (or asymptomatic, or non-specific) disease than severe clinical disease.…”

Respiratory extracorporeal membrane oxygenation for severe sepsis and septic shock in adults: a propensity score analysis in a multicenter retrospective observational study

“…The conventional ventilation versus ECMO for severe adult respiratory failure (CESAR) trial first reported a significant improvement in 6 months disability‐free survival in the ECMO group, when compared to conventional ventilation patients 5. Since then, several studies have shown the effectiveness of ECMO for influenza A (H1N1)‐related severe acute respiratory failure in 2009–2010 6, 7. Following the pandemic of influenza A (H1N1), however, few reports have explored the benefits of ECMO 8.…”