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[Extracorporeal lung support in patients with severe respiratory failure secondary to the 2010-2011 winter seasonal outbreak of influenza A (H1N1) in Spain].

Identifieur interne : 000288 ( Main/Exploration ); précédent : 000287; suivant : 000289

[Extracorporeal lung support in patients with severe respiratory failure secondary to the 2010-2011 winter seasonal outbreak of influenza A (H1N1) in Spain].

Auteurs : J. Bonastre [Espagne] ; B. Suberviola ; J C Pozo ; J E Guerrero ; A. Torres ; A. Rodríguez ; I. Martín-Loeches

Source :

RBID : pubmed:22341559

Descripteurs français

English descriptors

Abstract

OBJECTIVE

To describe the use of extracorporeal membrane oxygenation (ECMO) in refractory respiratory failure.

DESIGN

A prospective, observational, multi-center study was carried out.

SETTING

Intensive Care Units (ICU) in 148 Spanish hospitals.

PATIENTS

Subjects admitted during epidemic weeks 50-52 of 2010 and weeks 1-4 of 2011, receiving respiratory support with ECMO.

MAIN VARIABLES OF INTEREST

Clinical and blood gas features, complications and survival of patients with ECMO.

RESULTS

Out of 300 ICU admitted patients, 239 (79.6%) were mechanically ventilated. ECMO was available in only 5 ICUs. Nine patients were treated with ECMO (3% of the total and 3.2% of the ventilated patients). In 77.7% of the cases some hypoxemia rescue technique was previously used. ECMO was initiated when ARDS proved refractory to standard treatment. ECMO therapy was started a median of 4.5 days after the onset of mechanical ventilation. The median duration of ECMO was 6 days. Veno-venous (VV) ECMO was the most frequent cannulation mode (88.9%). Four patients had complications associated with ECMO therapy. The median ICU and hospital stay was 17 and 29 days, respectively. In five patients (55.5%), ECMO assistance was satisfactory suspended. The ICU and hospital survival rate was 44.4%.

CONCLUSIONS

The use of ECMO in refractory respiratory failure in patients with influenza A (H1N1) is rare in Spain. The hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.


DOI: 10.1016/j.medin.2011.12.004
PubMed: 22341559


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

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<term>Acute Kidney Injury (therapy)</term>
<term>Adult (MeSH)</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Disease Outbreaks (MeSH)</term>
<term>Extracorporeal Membrane Oxygenation (methods)</term>
<term>Extracorporeal Membrane Oxygenation (statistics & numerical data)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Influenza A Virus, H1N1 Subtype (isolation & purification)</term>
<term>Influenza, Human (complications)</term>
<term>Influenza, Human (drug therapy)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Intensive Care Units (statistics & numerical data)</term>
<term>Length of Stay (statistics & numerical data)</term>
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<term>Multiple Organ Failure (etiology)</term>
<term>Multiple Organ Failure (mortality)</term>
<term>Oseltamivir (therapeutic use)</term>
<term>Pneumonia, Viral (drug therapy)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pneumonia, Viral (etiology)</term>
<term>Pneumonia, Viral (therapy)</term>
<term>Prospective Studies (MeSH)</term>
<term>Renal Replacement Therapy (MeSH)</term>
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<term>Respiratory Distress Syndrome, Adult (epidemiology)</term>
<term>Respiratory Distress Syndrome, Adult (etiology)</term>
<term>Respiratory Distress Syndrome, Adult (therapy)</term>
<term>Respiratory Insufficiency (epidemiology)</term>
<term>Respiratory Insufficiency (etiology)</term>
<term>Respiratory Insufficiency (therapy)</term>
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<term>Shock, Septic (etiology)</term>
<term>Shock, Septic (mortality)</term>
<term>Spain (epidemiology)</term>
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<term>Atteinte rénale aigüe (étiologie)</term>
<term>Choc septique (mortalité)</term>
<term>Choc septique (étiologie)</term>
<term>Durée du séjour (statistiques et données numériques)</term>
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<term>Défaillance multiviscérale (étiologie)</term>
<term>Espagne (épidémiologie)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (complications)</term>
<term>Grippe humaine (traitement médicamenteux)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Insuffisance respiratoire (thérapie)</term>
<term>Insuffisance respiratoire (épidémiologie)</term>
<term>Insuffisance respiratoire (étiologie)</term>
<term>Mâle (MeSH)</term>
<term>Oséltamivir (usage thérapeutique)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (méthodes)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (statistiques et données numériques)</term>
<term>Pneumopathie virale (thérapie)</term>
<term>Pneumopathie virale (traitement médicamenteux)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Pneumopathie virale (étiologie)</term>
<term>Saisons (MeSH)</term>
<term>Sous-type H1N1 du virus de la grippe A (isolement et purification)</term>
<term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term>
<term>Syndrome de détresse respiratoire de l'adulte (épidémiologie)</term>
<term>Syndrome de détresse respiratoire de l'adulte (étiologie)</term>
<term>Traitement substitutif de l'insuffisance rénale (MeSH)</term>
<term>Unités de soins intensifs (statistiques et données numériques)</term>
<term>Ventilation artificielle (statistiques et données numériques)</term>
<term>Épidémies de maladies (MeSH)</term>
<term>Études prospectives (MeSH)</term>
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<term>Oseltamivir</term>
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<term>Influenza, Human</term>
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<term>Influenza, Human</term>
<term>Pneumonia, Viral</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Influenza, Human</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Distress Syndrome, Adult</term>
<term>Respiratory Insufficiency</term>
<term>Spain</term>
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<term>Acute Kidney Injury</term>
<term>Multiple Organ Failure</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Distress Syndrome, Adult</term>
<term>Respiratory Insufficiency</term>
<term>Shock, Septic</term>
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<term>Influenza A Virus, H1N1 Subtype</term>
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<term>Sous-type H1N1 du virus de la grippe A</term>
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<term>Extracorporeal Membrane Oxygenation</term>
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<term>Multiple Organ Failure</term>
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<term>Défaillance multiviscérale</term>
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<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
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<term>Extracorporeal Membrane Oxygenation</term>
<term>Intensive Care Units</term>
<term>Length of Stay</term>
<term>Respiration, Artificial</term>
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<term>Durée du séjour</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
<term>Unités de soins intensifs</term>
<term>Ventilation artificielle</term>
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<term>Acute Kidney Injury</term>
<term>Pneumonia, Viral</term>
<term>Respiratory Distress Syndrome, Adult</term>
<term>Respiratory Insufficiency</term>
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<term>Atteinte rénale aigüe</term>
<term>Insuffisance respiratoire</term>
<term>Pneumopathie virale</term>
<term>Syndrome de détresse respiratoire de l'adulte</term>
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<term>Grippe humaine</term>
<term>Insuffisance respiratoire</term>
<term>Pneumopathie virale</term>
<term>Syndrome de détresse respiratoire de l'adulte</term>
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<term>Atteinte rénale aigüe</term>
<term>Choc septique</term>
<term>Défaillance multiviscérale</term>
<term>Insuffisance respiratoire</term>
<term>Pneumopathie virale</term>
<term>Syndrome de détresse respiratoire de l'adulte</term>
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<term>Disease Outbreaks</term>
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<term>Humans</term>
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<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
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<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>To describe the use of extracorporeal membrane oxygenation (ECMO) in refractory respiratory failure.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>DESIGN</b>
</p>
<p>A prospective, observational, multi-center study was carried out.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>SETTING</b>
</p>
<p>Intensive Care Units (ICU) in 148 Spanish hospitals.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>PATIENTS</b>
</p>
<p>Subjects admitted during epidemic weeks 50-52 of 2010 and weeks 1-4 of 2011, receiving respiratory support with ECMO.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>MAIN VARIABLES OF INTEREST</b>
</p>
<p>Clinical and blood gas features, complications and survival of patients with ECMO.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Out of 300 ICU admitted patients, 239 (79.6%) were mechanically ventilated. ECMO was available in only 5 ICUs. Nine patients were treated with ECMO (3% of the total and 3.2% of the ventilated patients). In 77.7% of the cases some hypoxemia rescue technique was previously used. ECMO was initiated when ARDS proved refractory to standard treatment. ECMO therapy was started a median of 4.5 days after the onset of mechanical ventilation. The median duration of ECMO was 6 days. Veno-venous (VV) ECMO was the most frequent cannulation mode (88.9%). Four patients had complications associated with ECMO therapy. The median ICU and hospital stay was 17 and 29 days, respectively. In five patients (55.5%), ECMO assistance was satisfactory suspended. The ICU and hospital survival rate was 44.4%.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>The use of ECMO in refractory respiratory failure in patients with influenza A (H1N1) is rare in Spain. The hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.</p>
</div>
</front>
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<AbstractText Label="DESIGN" NlmCategory="METHODS">A prospective, observational, multi-center study was carried out.</AbstractText>
<AbstractText Label="SETTING" NlmCategory="METHODS">Intensive Care Units (ICU) in 148 Spanish hospitals.</AbstractText>
<AbstractText Label="PATIENTS" NlmCategory="METHODS">Subjects admitted during epidemic weeks 50-52 of 2010 and weeks 1-4 of 2011, receiving respiratory support with ECMO.</AbstractText>
<AbstractText Label="MAIN VARIABLES OF INTEREST" NlmCategory="METHODS">Clinical and blood gas features, complications and survival of patients with ECMO.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Out of 300 ICU admitted patients, 239 (79.6%) were mechanically ventilated. ECMO was available in only 5 ICUs. Nine patients were treated with ECMO (3% of the total and 3.2% of the ventilated patients). In 77.7% of the cases some hypoxemia rescue technique was previously used. ECMO was initiated when ARDS proved refractory to standard treatment. ECMO therapy was started a median of 4.5 days after the onset of mechanical ventilation. The median duration of ECMO was 6 days. Veno-venous (VV) ECMO was the most frequent cannulation mode (88.9%). Four patients had complications associated with ECMO therapy. The median ICU and hospital stay was 17 and 29 days, respectively. In five patients (55.5%), ECMO assistance was satisfactory suspended. The ICU and hospital survival rate was 44.4%.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The use of ECMO in refractory respiratory failure in patients with influenza A (H1N1) is rare in Spain. The hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.</AbstractText>
<CopyrightInformation>Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.</CopyrightInformation>
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<VernacularTitle>Uso de oxigenador de membrana extracorpóreo en pacientes con insuficiencia respiratoria aguda grave refractaria en la epidemia de gripe estacional 2010-2011 por influenza A (H1N1) en España.</VernacularTitle>
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<MeshHeading>
<DescriptorName UI="D004196" MajorTopicYN="Y">Disease Outbreaks</DescriptorName>
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<MeshHeading>
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<DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName>
<QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName>
<QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007902" MajorTopicYN="N">Length of Stay</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D009102" MajorTopicYN="N">Multiple Organ Failure</DescriptorName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D053139" MajorTopicYN="N">Oseltamivir</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName>
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<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D017582" MajorTopicYN="N">Renal Replacement Therapy</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
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<DescriptorName UI="D012131" MajorTopicYN="N">Respiratory Insufficiency</DescriptorName>
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<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
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<DescriptorName UI="D013030" MajorTopicYN="N">Spain</DescriptorName>
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<History>
<PubMedPubDate PubStatus="received">
<Year>2011</Year>
<Month>10</Month>
<Day>03</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised">
<Year>2011</Year>
<Month>11</Month>
<Day>28</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2011</Year>
<Month>12</Month>
<Day>08</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2012</Year>
<Month>2</Month>
<Day>21</Day>
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<PubMedPubDate PubStatus="pubmed">
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<PubMedPubDate PubStatus="medline">
<Year>2012</Year>
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<PublicationStatus>ppublish</PublicationStatus>
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<ArticleId IdType="pii">S0210-5691(12)00008-3</ArticleId>
<ArticleId IdType="doi">10.1016/j.medin.2011.12.004</ArticleId>
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<affiliations>
<list>
<country>
<li>Espagne</li>
</country>
</list>
<tree>
<noCountry>
<name sortKey="Guerrero, J E" sort="Guerrero, J E" uniqKey="Guerrero J" first="J E" last="Guerrero">J E Guerrero</name>
<name sortKey="Martin Loeches, I" sort="Martin Loeches, I" uniqKey="Martin Loeches I" first="I" last="Martín-Loeches">I. Martín-Loeches</name>
<name sortKey="Pozo, J C" sort="Pozo, J C" uniqKey="Pozo J" first="J C" last="Pozo">J C Pozo</name>
<name sortKey="Rodriguez, A" sort="Rodriguez, A" uniqKey="Rodriguez A" first="A" last="Rodríguez">A. Rodríguez</name>
<name sortKey="Suberviola, B" sort="Suberviola, B" uniqKey="Suberviola B" first="B" last="Suberviola">B. Suberviola</name>
<name sortKey="Torres, A" sort="Torres, A" uniqKey="Torres A" first="A" last="Torres">A. Torres</name>
</noCountry>
<country name="Espagne">
<noRegion>
<name sortKey="Bonastre, J" sort="Bonastre, J" uniqKey="Bonastre J" first="J" last="Bonastre">J. Bonastre</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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