This article is more than 5 years old. Information may no longer be current.
Extracorporeal membrane oxygenation decreased mortality in severe H1N1
Noah MA. JAMA. 2011;doi:10.1001/jama.2011.1471.
Click Here to Manage Email Alerts
Patients with severe H1N1-associated acute respiratory distress syndrome were twice as likely to survive when referred and transferred to an extracorporeal membrane oxygenation center when compared with those not referred.
Of the 80 patients referred to a center, 86.3% received extracorporeal membrane oxygenation and 27.5% died before hospital discharge. When the researchers individually matched 59 pairs of referred and non-referred patients, the rate for hospital mortality was 23.7% vs. 52.5%, respectively (RR=0.45; 95% CI, 0.26-0.79).
“Care for patients with severe but potentially reversible respiratory failure should be concentrated into institutions that can offer a full range of respiratory treatments, including extracorporeal membrane oxygenation,” Giles J. Peek, MD, of the Glenfield Hospital in Leicester, England, told Infectious Disease News. “It is also essential to stress the important preventive role of immunization, which could have prevented the pandemic in the first place.”
Hospital mortality was assessed among patients with H1N1-associated acute respiratory distress syndrome who were referred and transferred to one of four adult extracorporeal membrane oxygenation centers in the United Kingdom during the 2009-2010 H1N1 winter pandemic. Results were then compared with matching patients not referred to a center.
Of 75 pairs of referred and non-referred patients matched by propensity score, hospital mortality was 24% vs. 46.7%, respectively (RR=0.51; 95% CI, 0.31-0.81). Of 75 pairs identified with GenMatch, hospital mortality was 24% vs. 50.7%, respectively (RR=0.47; 95% CI, 0.31-0.72). – by Ashley DeNyse
Disclosure: The researchers used data from The SwiFT study, which was funded by the National Institute for Health Research and has been published in full in the Health Technology Assessment journal series.
This is a very rigorous and interesting study and it ought to renew the discussions about the role of extracorporeal membrane oxygenation in the treatment of seriously ill adult patients who have influenza. Unlike the UK, where they have designated extracorporeal membrane oxygenation centers, we do not have that in the US. Much, almost all, of the extracorporeal membrane oxygenation that is done in the US is done in pediatric hospitals. We, at Vanderbilt University, have used extracorporeal membrane oxygenation on occasion with the collaboration of our pediatric colleagues during the 2009 H1N1 pandemic on just a few patients. It requires organization and training, but I think this paper will stimulate, in many medical centers, the potential role of extracorporeal membrane oxygenation going into the future, regarding adult patients with influenza.
– William Schaffner, MD
Infectious Disease News Editorial Board member
President, NFID
Disclosure: Dr. Schaffner reports no relevant financial disclosures.
 |
Follow InfectiousDiseaseNews.com on Twitter. |