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Oxygenating system improved H1N1 survival

Kathleen Blanchard's picture

Respiratory failure from H1N1 flu is has been responsible for critical illness caused by the virus. Findings published in JAMA show that most patients in New Zealand and Australia who developed respiratory failure from H1N1 flu survived with the use of an oxygen system called ECMO (extracorporeal membrane oxygenation).

The ECMO oxygenation system that was found to help H1N1 patients survive is similar to a heart-lung machine. Tubes called cannulas are inserted into the large blood vessels to directly provide oxygen the blood, bypassing the work normally performed by the lungs.

According to the review, some patients were given ECMO that adds oxygen to a patients circulating blood. The study, conducted by the Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators in collaboration with the Australian and New Zealand Intensive Care Research Centre at Monash University in Melbourne, provides information that can assist physicians in caring for critically ill patients who develop respiratory failure that has lead to ARDS (adult respiratory distress syndrome) from H1N1 flu.

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ARDS causes fluid buildup in the lungs and respiratory failure, and has been responsible for H1N1 severity and death in younger adults. The study showed 54 out of 68 patients treated with ECMO who had ARDS survived, at the time of the report. The average age of the patients was 34.4 years, and half were men. The patients were admitted to ICU’s in Australia and New Zealand between June 1 and August 31, 2009.

Additional data includes 133 H1N1 patients with H1N1 on mechanical ventilators who did not receive ECMO therapy. The authors say, "Affected patients were often young adults, pregnant or postpartum, obese, had severe respiratory failure before ECMO, and received prolonged mechanical ventilation and ECMO support."

The authors found that ECMO oxygen system can improve survival in patients critically ill from the respiratory effects of H1N1 flu. "Despite their illness severity and the prolonged use of life support, most of these patients survived. This information should facilitate health care planning and clinical management for these complex patients during the ongoing (H1N1 flu) pandemic." ECMO was provided to improve oxygenation in the blood for an average of ten days. Thirty three patients were discharged to home.

JAMA. 2009;302(17):doi:10.1001/JAMA.2009.1535