Most H1N1 patients with respiratory failure treated with oxygenating system survive illness

Oct 12, 2009

Despite the severity of disease and the intensity of treatment, most patients in Australia and New Zealand who experienced respiratory failure as a result of 2009 influenza A(H1N1) and were treated with a system that adds oxygen to the patient's blood survived the disease, according to a study to appear in the November 4 issue of JAMA. This study is being published early online because of its public health importance.

The influenza A(H1N1) pandemic affected Australia and New Zealand during the 2009 southern hemisphere winter, causing an epidemic of critical illness. Some patients developed severe (ARDS) and were treated with extracorporeal membrane oxygenation (ECMO), according to background information in the article.

ARDS is a lung condition that leads to due to the rapid accumulation of fluid in the lungs. ECMO is a type of life support that circulates blood through a system that adds oxygen. ECMO was used for the patients in this study because they developed very low blood oxygen levels that developed rapidly despite standard ventilator (or respirator) settings. ECMO is generally used for a limited time because of the risks of bleeding, clotting, infection, and .

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, conducted an observational study of patients with 2009 influenza A(H1N1)-associated ARDS treated with ECMO in 15 intensive care units (ICUs) in Australia and New Zealand between June 1 and August 31, 2009. The researchers looked at incidence, clinical features, the degree of lung dysfunction, technical characteristics, the duration of ECMO, complications, and survival.

The study found that 68 patients with severe influenza-associated ARDS were treated with ECMO, including 53 with confirmed 2009 influenza A(H1N1). An additional 133 patients with A received mechanical ventilation, but not ECMO, in the same ICUs. The 68 patients who received ECMO had a median (midpoint) age of 34.4 years and half were men.

"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 write.

The median duration of ECMO support was ten days. At the time of reporting, 54 of the 68 patients had survived and 14 (21 percent) had died. Six patients remained in ICU, including two who were still receiving ECMO. Sixteen patients were still hospitalized, but out of ICU, and 32 had been discharged from the hospital.

"Despite their illness severity and the prolonged use of life support, most of these patients survived," the authors conclude. "This information should facilitate health care planning and clinical management for these complex patients during the ongoing pandemic."

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

Source: JAMA and Archives Journals (news : web)

Explore further: Recorded Ebola deaths top 7,000

add to favorites email to friend print save as pdf

Related Stories

Hemofiltration during extracorporeal membrane oxygenation

Apr 02, 2009

Haemofiltration has already been shown to improve fluid balance in children treated with extracorporeal membrane oxygenation (ECMO) but now researchers writing in BioMed Central's open access journal Critical Care have r ...

Lessons learned from H1N1 virus pandemic

Oct 09, 2009

A comprehensive study has revealed, for the first time, the impact of swine flu on the health of the general public in Australia and New Zealand.

Recommended for you

Recorded Ebola deaths top 7,000

18 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

22 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.