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Extracorporeal membrane oxygenation for pandemic H1N1 2009 respiratory failure
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- Holzgraefe, B. (författare)
- Karolinska Institutet
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- Broome, Michael (författare)
- Karolinska Institutet
- Kalzen, H. (författare)
- visa fler...
- Palmer, K. (författare)
- visa färre...
- (creator_code:org_t)
- 2010
- 2010
- Engelska.
- Ingår i: Minerva Anestesiologica. - 0375-9393 .- 1827-1596. ; 76:12, s. 1043-1051
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- BACKGROUND: Severe respiratory failure related to infection with the pandemic influenza A/H1N1 2009 virus is uncommon but possibly life-threatening. If, in spite of maximal conventional critical care, the patient's condition deteriorates, extracorporeal membrane oxygenation (ECMO) may be a life-saving procedure. METHODS: An observational study approved by the local ethics committee was carried out. Data from all patients treated with ECMO at the ECMO Center Karolinska for influenza A/H1N1 2009-related severe respiratory failure were analyzed. The main outcome measure was survival three months after discharge from our department. RESULTS: Between July 2009 and January 2010, 13 patients with H1N1 2009 respiratory failure were treated with ECMO. Twelve patients were cannulated for veno-venous ECMO at the referring hospital and transported to Stockholm. One patient was cannulated in our hospital for veno-arterial support. The median ratio of the arterial partial oxygen pressure to the fraction of inspired oxygen (P/F ratio: PaO2 /FiO2) before cannulation was 52.5 (interquartile range 38-60). Four patients were converted from veno-venous to veno-arterial ECMO because of right heart failure (three) or life-threatening cardiac arrhythmias (one). The median maximum oxygen consumption via ECMO was 251 ml/min (187-281 ml/min). Twelve patients were still alive three months after discharge; one patient died four days after discharge due to intracranial hemorrhage. CONCLUSION: Patients treated with veno-venous or veno-arterial ECMO for H1N1 2009-related respiratory failure may have a favorable outcome. Contributing factors may include the possibility of transport on ECMO, conversion from veno-venous (v-v) or veno-arterial (v-a) ECMO if necessary, high-flow ECMO to meet oxygen requirements and active surgery when needed.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Adult
- Analgesics/therapeutic use
- Anoxia/therapy
- Cohort Studies
- Cross Infection/therapy
- *Extracorporeal Membrane Oxygenation/adverse effects/instrumentation
- Female
- Humans
- Hypnotics and Sedatives/therapeutic use
- *Influenza A Virus
- H1N1 Subtype
- Influenza
- Human/complications/*therapy/virology
- Male
- Middle Aged
- Pandemics
- Pregnancy
- Respiration
- Artificial
- Respiratory Function Tests
- Respiratory Insufficiency/etiology/*therapy/virology
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
- Holzgraefe, B.
- Broome, Michael
- Kalzen, H.
- Konrad, D.
- Palmer, K.
- Frenckner, B.
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
- MEDICIN OCH HÄLS ...
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- Kungliga Tekniska Högskolan
- Karolinska Institutet
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