A Davies

A Peris

Adriano Peris

Alberta Azzi

Andrea Pasquini

B Bouhemad

C Arbelot

C Warren-Gash

C Waydhas

CE Colby

Chiara Lazzeri

D Herbst

DA Lichtenstein

DH Freed

G Chowell

GA Schmidt

Gianfranco Gensini

Giovanni Cianchi

Giovanni Zagli

GJ Peek

Guido Sani

IJ Welsby

J Phua

J Rello

K Wagner

L Tutino

LP Voigt

M Balik

M Zambon

Manuela Bonizzoli

Marco Ciapetti

Massimo Bonacchi

MK Lidegran

Pasquale Bernardo

PH Mayo

R Perez-Padilla

RG Brower

Rosanna Abbate

S Jain

SA Webb

Simona Biondi

Stefano Batacchi

TV Brogan

TW Weiss

V Linden

Valtere Giovannini

W Muntean

English

PubMed

n ID="         
                
                  Stefano Batacchi

Cianchi, Giovanni

Springer

Ventilatory and ECMO treatment of H1N1-induced severe respiratory failure: results of an Italian referral ECMO center

Abstract
          
            Background
            Since the first outbreak of a respiratory illness caused by H1N1 virus in Mexico, several reports have described the need of intensive care or extracorporeal membrane oxygenation (ECMO) assistance in young and often healthy patients. Here we describe our experience in H1N1-induced ARDS using both ventilation strategy and ECMO assistance.
          
          
            Methods
            Following Italian Ministry of Health instructions, an Emergency Service was established at the Careggi Teaching Hospital (Florence, Italy) for the novel pandemic influenza. From Sept 09 to Jan 10, all patients admitted to our Intensive Care Unit (ICU) of the Emergency Department with ARDS due to H1N1 infection were studied. All ECMO treatments were veno-venous. H1N1 infection was confirmed by PCR assayed on pharyngeal swab, subglottic aspiration and bronchoalveolar lavage. Lung pathology was evaluated daily by lung ultrasound (LUS) examination.
          
          
            Results
            A total of 12 patients were studied: 7 underwent ECMO treatment, and 5 responded to protective mechanical ventilation. Two patients had co-infection by Legionella Pneumophila. One woman was pregnant. In our series, PCR from bronchoalveolar lavage had a 100% sensitivity compared to 75% from pharyngeal swab samples. The routine use of LUS limited the number of chest X-ray examinations and decreased transportation to radiology for CT-scan, increasing patient safety and avoiding the transitory disconnection from ventilator. No major complications occurred during ECMO treatments. In three cases, bleeding from vascular access sites due to heparin infusion required blood transfusions. Overall mortality rate was 8.3%.
          
          
            Conclusions
            In our experience, early ECMO assistance resulted safe and feasible, considering the life threatening condition, in H1N1-induced ARDS. Lung ultrasound is an effective mean for daily assessment of ARDS patients.
          </jats:sec

Crossref

BMC Pulmonary Medicine

Springer - Publisher Connector

Bonacchi, Massimo

Sani, Guido

Azzi, Alberta

Abbate, Rosanna

Gensini, Gian Franco

Florence Research

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Ventilatory and ECMO treatment of H1N1-induced severe respiratory failure: results of an Italian referral ECMO center

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