Skip to main content

Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A.

Publication ,  Journal Article
Turner, DA; Rehder, KJ; Peterson-Carmichael, SL; Ozment, CP; Al-Hegelan, MS; Williford, WL; Peters, MA; Noble, PW; Cheifetz, IM
Published in: Respir Care
July 2011

BACKGROUND: Respiratory failure and acute respiratory distress syndrome secondary to H1N1 influenza infection is a source of substantial morbidity and mortality, having caused over 265,000 hospitalizations in the United States in 2009. During the H1N1 pandemic, up to 31% of the H1N1 patients required intensive care unit admission, and many were refractory to maximal conventional therapies. These most critically ill patients may require extracorporeal membrane oxygenation (ECMO) for survival. METHODS: We retrospectively reviewed the medical records of the 7 patients with refractory hypoxemia due to H1N1 influenza who were treated with ECMO in our pediatric intensive care unit. RESULTS: Five of the 7 patients survived to hospital discharge. The cohort's mean age was 21 years, and 4 were female. At admission to the pediatric intensive care unit, 6 had at least one comorbid condition, 6 were mechanically ventilated, and one was in shock. All 7 patients were treated with oral oseltamivir, high-frequency oscillatory ventilation, and inhaled nitric oxide prior to ECMO. Five received intravenous steroids, and 2 were treated with compassionate-use intravenous zanamivir. The mean duration of pre-ECMO ventilation was 8.7 days (range 14 h to 25 d). Mean oxygenation index was 50 (range 26-73) at ECMO cannulation. Six received venovenous ECMO, and one received venoarterial ECMO. The mean duration of ECMO was 432 hours (range 192-890 h). CONCLUSIONS: This series suggests that ECMO is a viable treatment for refractory hypoxemia secondary to H1N1 influenza infection in both pediatric and adult patients.

Duke Scholars

Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

July 2011

Volume

56

Issue

7

Start / End Page

941 / 946

Location

United States

Related Subject Headings

  • Zanamivir
  • Young Adult
  • Retrospective Studies
  • Respiratory System
  • Respiratory Insufficiency
  • Oseltamivir
  • Male
  • Intensive Care Units, Pediatric
  • Influenza, Human
  • Influenza A Virus, H1N1 Subtype
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Turner, D. A., Rehder, K. J., Peterson-Carmichael, S. L., Ozment, C. P., Al-Hegelan, M. S., Williford, W. L., … Cheifetz, I. M. (2011). Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A. Respir Care, 56(7), 941–946. https://doi.org/10.4187/respcare.01066
Turner, David A., Kyle J. Rehder, Stacey L. Peterson-Carmichael, Caroline P. Ozment, Mashael S. Al-Hegelan, Walter L. Williford, Michelle A. Peters, Paul W. Noble, and Ira M. Cheifetz. “Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A.Respir Care 56, no. 7 (July 2011): 941–46. https://doi.org/10.4187/respcare.01066.
Turner DA, Rehder KJ, Peterson-Carmichael SL, Ozment CP, Al-Hegelan MS, Williford WL, et al. Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A. Respir Care. 2011 Jul;56(7):941–6.
Turner, David A., et al. “Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A.Respir Care, vol. 56, no. 7, July 2011, pp. 941–46. Pubmed, doi:10.4187/respcare.01066.
Turner DA, Rehder KJ, Peterson-Carmichael SL, Ozment CP, Al-Hegelan MS, Williford WL, Peters MA, Noble PW, Cheifetz IM. Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza A. Respir Care. 2011 Jul;56(7):941–946.

Published In

Respir Care

DOI

ISSN

0020-1324

Publication Date

July 2011

Volume

56

Issue

7

Start / End Page

941 / 946

Location

United States

Related Subject Headings

  • Zanamivir
  • Young Adult
  • Retrospective Studies
  • Respiratory System
  • Respiratory Insufficiency
  • Oseltamivir
  • Male
  • Intensive Care Units, Pediatric
  • Influenza, Human
  • Influenza A Virus, H1N1 Subtype