Extracorporeal Membrane Oxygenation for ARDS: National Trends in the United States 2008–2012

Natt, Bhupinder; Desai, Hem; Singh, Nirmal; Poongkunran, Chithra; Parthasarathy, Sairam; Bime, Christian

doi:10.4187/respcare.04760

Cited by 24 publications

(28 citation statements)

References 26 publications

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“…The overall use of ECMO for treatment of ARDS has increased with improvement in mortality (147). The recent PALICC recommendations conclude that ECMO should be considered for treatment of pARDS when lung-protective strategies have failed, when the cause of respiratory failure is thought to be reversible, or when the child may be suitable for lung transplantation (148).…”

Section: Treatment Options Available For Rsv and Influenza A (H1n1) Vmentioning

confidence: 99%

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

2016

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Viral infections are an important cause of pediatric acute respiratory distress syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in “at risk” populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral-related ARDS have yet to be determined. This review outlines what is known about ARDS secondary to viral infections including the epidemiology, the pathophysiology, and diagnosis. In addition, emerging treatment options to prevent infection, and to decrease disease burden will be outlined. We focused on RSV and influenza A (H1N1) viral-induced ARDS, as these are the most common viruses leading to pediatric ARDS, and have specific prophylactic and definitive treatment options.

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Section: Treatment Options Available For Rsv and Influenza A (H1n1) Vmentioning

confidence: 99%

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

2016

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“…1). In this investigation, Natt et al 1 demonstrate a concomitant decrease in both mortality and hospital stay in subjects receiving ECMO during the course of the study period (2008 -2012). Although this association is clear and statistically significant, the reasons for improvements in outcome are unclear.…”

mentioning

confidence: 55%

“…In this issue of RESPIRATORY CARE, Natt et al 1 present a retrospective review of a large administrative database, looking at trends in use of extracorporeal membrane oxygenation (ECMO) in adults with ARDS. As the authors note, ECMO utilization for adult ARDS has undoubtedly increased, and that trend is continuing.…”

mentioning

confidence: 99%

Is Extracorporeal Membrane Oxygenation Saving Lives, or Are We Just Using It in Healthier Patients?

Rehder

Turner

2016

Respir Care

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“…Based on our previous publications, we believe that HCUP procedural codes are an accurate way to create a cohort. 5 The ILI database requires out-patient providers to report to the CDC. The criteria for ILI may not be specific enough, and the demands for self-report may be too great to capture the true incidence of out-patient influenza.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] There was a significant increase in ECMO use for ARDS in the United States during the 2009 H1N1 influenza epidemic. 4,5 The development of ARDS following H1N1 infection af-fected young adults who were otherwise amenable to ECMO. 6,7 ECMO programs subsequently learned that they needed to be able to scale up quickly in anticipation of future outbreaks.…”

Section: Introductionmentioning

confidence: 99%

The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis

et al. 2018

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BACKGROUND: The 2009 H1N1 influenza epidemic saw a rise in the use of extracorporeal membrane oxygenation (ECMO) as a supportive therapy for refractory ARDS. We sought to determine whether ECMO utilization follows a seasonal pattern that matches the influenza season, and whether it can further be explained by the incidence of each influenza subtype. METHODS: We performed a longitudinal analysis of non-cardiac and cardiac-associated ECMO cases from the National In-patient Sample from 2005 to 2014, using overdispersed Poisson regression to evaluate associations with influenza incidence categorized by influenza-like illness and total positive influenza tests divided by subtype from the Centers for Disease Control and Prevention. RESULTS: Non-cardiac ECMO use was positively associated with influenza-like illness incidence in the current month (incidence risk ratio [IRR] 1.11, 95% confidence interval [CI] 1.07-1.15, P < .001) and with influenza-like illness in the previous month (IRR 1.09, 95% CI 1.05-1.14, P < .001). The 2009 H1N1 subtype had the strongest association with non-cardiac ECMO (IRR 1.19, 95% CI 1.09-1.31, P < .001). Cardiac ECMO was also positively associated with the incidence of influenza-like illness (IRR 1.05, 95% CI 1.01-1.09, P ‫؍‬ .02). CONCLUSION: Non-cardiac and cardiac ECMO use in the United States were significantly associated with influenza incidence. The influenza A, H1N1 2009, subtype had the strongest association.

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Extracorporeal Membrane Oxygenation for ARDS: National Trends in the United States 2008–2012

Abstract: In the United States, between 2008 and 2012, there was an increasing trend toward the use of ECMO in patients with ARDS that coincided with a slight increase in survival among these patients.

Cited by 24 publications

References 26 publications

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

Is Extracorporeal Membrane Oxygenation Saving Lives, or Are We Just Using It in Healthier Patients?

The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis

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