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Oxygenating system associated with lower risk of death for H1N1 patients with respiratory failure
Date:10/5/2011

CHICAGO Patients with severe 2009 H1N1 influenza who developed respiratory failure and were treated with a system that adds oxygen to the patient's blood had a lower rate of in-hospital death than similar patients who did not receive this treatment, according to a study appearing in JAMA. The study is being published early online to coincide with its presentation at the European Society of Intensive Care Medicine meeting in Berlin.

Extracorporeal membrane oxygenation (ECMO) is a type of life support that circulates blood through a system that adds oxygen. "ECMO may be used either as a rescue intervention or to minimize ventilator-associated lung injury and its associated multiple organ dysfunction, both crucial determinants of survival for patients with acute respiratory distress syndrome [ARDS; a lung condition that leads to respiratory failure due to the rapid accumulation of fluid in the lungs]," the authors write. A previous study found more favorable outcomes for patients with severe ARDS if they were transferred to a single ECMO center. However, various factors could have affected the results. "Moreover, ECMO doubled hospital costs compared with conventional care. Hence, the role of ECMO in adults with severe ARDS remains controversial.''

Moronke A. Noah, M.R.C.S., of the Heartlink ECMO Centre, Glenfield Hospital, Leicester, England, and colleagues conducted a study to examine the mortality of patients with influenza A(H1N1)-related ARDS who were referred, accepted, and transferred to 1 of the 4 adult ECMO centers in the United Kingdom during the pandemic in winter 2009-2010. The ECMO-referred patients were matched with non- ECMO-referred patients using data from a longitudinal cohort study (Swine Flu Triage study) of critically ill patients with suspected or confirmed H1N1. Detailed demographic, physiological, and comorbidity data were used in 3 different matching techniques (individual, propensity score, and GenMatch).


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Contact: Giles J. Peek, F.R.C.S., (C.Th.), M.D.
giles.peek@uhl-tr.nhs.uk
JAMA and Archives Journals
Source:Eurekalert

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