| Extracorporeal membrane oxygenation for pandemic H1N1 2009 respiratory failure. | |
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MedLine Citation:
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PMID: 21178913 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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B Holzgraefe; M Broomé; H Kalzén; D Konrad; K Palmér; B Frenckner |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Minerva anestesiologica Volume: 76 ISSN: 1827-1596 ISO Abbreviation: Minerva Anestesiol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375272 Medline TA: Minerva Anestesiol Country: Italy |
Other Details:
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Languages: eng Pagination: 1043-51 Citation Subset: IM |
Affiliation:
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Section for Anaesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Paediatric Anaesthesia and Intensive Care, ECMO Center Karolinska, Karolinska Institute and Karolinska University Hospital Solna, Stockholm, Sweden. bernhard.holzgraefe@karolinska.se |
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Comment In:
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Minerva Anestesiol. 2010 Dec;76(12):989-91
[PMID:
21178910
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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