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Open Access 01-10-2012 | Original Article

Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan

Authors: Shinhiro Takeda, Toru Kotani, Satoshi Nakagawa, Shingo Ichiba, Toshiyuki Aokage, Ryoichi Ochiai, Nobuyuki Taenaka, Kaneyuki Kawamae, Masaji Nishimura, Yoshihito Ujike, Kimitaka Tajimi, Committee of Crisis Control, the Japanese Society of Respiratory Care Medicine and Committee of Pandemic H1N1 Surveillance, the Japanese Society of Intensive Care Medicine

Published in: Journal of Anesthesia | Issue 5/2012

Abstract

Purpose

To evaluate procedures and outcomes of extracorporeal membrane oxygenation (ECMO) therapy applied to 2009 influenza A(H1N1) severe respiratory failure patients in Japan.

Methods

This observational study used database information about adults who received ECMO therapy for H1N1-related severe respiratory failure from April 1, 2010 to March 31, 2011.

Results

Fourteen patients from 12 facilities were enrolled. Anti-influenza drugs were used in all cases. Before the start of ECMO, the lowest PaO₂/FiO₂ was median (interquartile) of 50 (40–55) mmHg, the highest peak inspiratory pressure was 30 (29–35) cmH₂O, and mechanical ventilation had been applied for at least 7 days in 5 patients. None of the facilities had extensive experience with ECMO for respiratory failure (6 facilities, no previous experience; 5 facilities, one or two cases annually). The blood drainage cannula was smaller than 20 Fr. in 10 patients (71.4 %). The duration of ECMO was 8.5 (4.0–10.8) days. The duration of each circuit was only 4.0 (3.2–5.3) days, and the ECMO circuit had to be renewed 19 times (10 cases). Thirteen patients (92.9 %) developed adverse events associated with ECMO, such as oxygenator failure, massive bleeding, and disseminated intravascular coagulation. The survival rate was 35.7 % (5 patients).

Conclusion

ECMO therapy for H1N1-related severe respiratory failure in Japan has very poor outcomes, and most patients developed adverse events. However, this result does not refute the effectiveness of ECMO. One possible cause of these poor outcomes is the lack of satisfactory equipment, therapeutic guidelines, and systems for patient transfer to central facilities.

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Title: Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan
Authors: Shinhiro Takeda
Toru Kotani
Satoshi Nakagawa
Shingo Ichiba
Toshiyuki Aokage
Ryoichi Ochiai
Nobuyuki Taenaka
Kaneyuki Kawamae
Masaji Nishimura
Yoshihito Ujike
Kimitaka Tajimi
Committee of Crisis Control, the Japanese Society of Respiratory Care Medicine and Committee of Pandemic H1N1 Surveillance, the Japanese Society of Intensive Care Medicine
Publication date: 01-10-2012
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 5/2012
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-012-1402-x

ACC 2024 Congress

Springer Medicine

Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) severe respiratory failure in Japan

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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