BACKGROUND: The investigators compared a series of adult survivors of severe H1N1 pneumonia treated with extracorporeal membrane oxygenation (ECMO) with members of the Extracorporeal Life Support Organization registry for patients with H1N1 with regard to ventilator management while on ECMO. METHODS: Adults who survived ECMO were compared regarding time on ECMO for those treated with the Volume Diffusive Respirator (VDR) or with conventional "lung rest." The VDR delivered 500 percussions/min, with tidal pressures of 24/12 cm H2O and a fraction of inspired oxygen of .4 at 15 beats/min. RESULTS: There were no differences between the study patients (n = 7) and the Extracorporeal Life Support Organization cohort (n = 150) regarding age, pre-ECMO ventilator days, pre-ECMO ratio of partial pressure of oxygen to fraction of inspired oxygen, or survival after lung recovery. Patients treated with VDR required ECMO support for a shorter duration (mean, 193.29 ± 35.71 vs 296.63 ± 18.17 hours; P = .029). CONCLUSIONS: These data suggest that the VDR enhanced pulmonary recovery from severe H1N1 pneumonia in adults. Shorter times on ECMO may improve the risk/benefit and cost/benefit ratios associated with ECMO care.
BACKGROUND: The investigators compared a series of adult survivors of severe H1N1pneumonia treated with extracorporeal membrane oxygenation (ECMO) with members of the Extracorporeal Life Support Organization registry for patients with H1N1 with regard to ventilator management while on ECMO. METHODS: Adults who survived ECMO were compared regarding time on ECMO for those treated with the Volume Diffusive Respirator (VDR) or with conventional "lung rest." The VDR delivered 500 percussions/min, with tidal pressures of 24/12 cm H2O and a fraction of inspired oxygen of .4 at 15 beats/min. RESULTS: There were no differences between the study patients (n = 7) and the Extracorporeal Life Support Organization cohort (n = 150) regarding age, pre-ECMO ventilator days, pre-ECMO ratio of partial pressure of oxygen to fraction of inspired oxygen, or survival after lung recovery. Patients treated with VDR required ECMO support for a shorter duration (mean, 193.29 ± 35.71 vs 296.63 ± 18.17 hours; P = .029). CONCLUSIONS: These data suggest that the VDR enhanced pulmonary recovery from severe H1N1pneumonia in adults. Shorter times on ECMO may improve the risk/benefit and cost/benefit ratios associated with ECMO care.
Authors: Jonathan D Marhong; Laveena Munshi; Michael Detsky; Teagan Telesnicki; Eddy Fan Journal: Intensive Care Med Date: 2015-03-10 Impact factor: 17.440
Authors: Charles Oribabor; Iosif Gulkarov; Felix Khusid; Emma Fischer Ms; Adebayo Esan; Nancy Rizzuto; Anthony Tortolani; Paris Ayanna Dattilo; Kaki Suen; Justin Ugwu; Brent Kenney Journal: Can J Respir Ther Date: 2018-11-01