The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks
Identifieur interne : 001A81 ( Istex/Corpus ); précédent : 001A80; suivant : 001A82The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks
Auteurs : Nicol Patroniti ; Alberto Zangrillo ; Federico Pappalardo ; Adriano Peris ; Giovanni Cianchi ; Antonio Braschi ; Giorgio A. Iotti ; Antonio Arcadipane ; Giovanna Panarello ; V. Marco Ranieri ; Pierpaolo Terragni ; Massimo Antonelli ; Luciano Gattinoni ; Fabrizio Oleari ; Antonio PesentiSource :
- Intensive Care Medicine [ 0342-4642 ] ; 2011-09-01.
English descriptors
Abstract
Abstract: Purpose: In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. Methods: The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions. Results: Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality. Conclusions: A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.
Url:
DOI: 10.1007/s00134-011-2301-6
Links to Exploration step
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<front><div type="abstract" xml:lang="en">Abstract: Purpose: In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. Methods: The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions. Results: Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality. Conclusions: A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.</div>
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<abstract>Abstract: Purpose: In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. Methods: The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions. Results: Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality. Conclusions: A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.</abstract>
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<affiliation>Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, 20052, Monza, Italy</affiliation>
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<author xml:id="author-0001"><persName><forename type="first">Alberto</forename>
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<author xml:id="author-0002"><persName><forename type="first">Federico</forename>
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<author xml:id="author-0003"><persName><forename type="first">Adriano</forename>
<surname>Peris</surname>
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<affiliation>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza, Azienda Ospedaliero Universitaria Careggi, Florence, Italy</affiliation>
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<author xml:id="author-0004"><persName><forename type="first">Giovanni</forename>
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<author xml:id="author-0013"><persName><forename type="first">Fabrizio</forename>
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<abstract xml:lang="en"><p>Abstract: Purpose: In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. Methods: The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions. Results: Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality. Conclusions: A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.</p>
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<Country Code="IT">Italy</Country>
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<Affiliation ID="Aff4"><OrgDivision>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza</OrgDivision>
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<Country Code="IT">Italy</Country>
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<Country Code="IT">Italy</Country>
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<OrgAddress><City>Pavia</City>
<Country Code="IT">Italy</Country>
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<Country Code="IT">Italy</Country>
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<OrgAddress><Street>Ospedale S. Giovanni Battista-Molinette</Street>
<City>Turin</City>
<Country Code="IT">Italy</Country>
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<OrgName>Università Cattolica del Sacro Cuore</OrgName>
<OrgAddress><City>Rome</City>
<Country Code="IT">Italy</Country>
</OrgAddress>
</Affiliation>
<Affiliation ID="Aff10"><OrgDivision>Dipartimento di Anestesiologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Maggiore Policlinico</OrgDivision>
<OrgName>Università degli Studi di Milano</OrgName>
<OrgAddress><City>Milan</City>
<Country Code="IT">Italy</Country>
</OrgAddress>
</Affiliation>
<Affiliation ID="Aff11"><OrgDivision>Dipartimento della Prevenzione e Comunicazione</OrgDivision>
<OrgName>Ministero della Salute</OrgName>
<OrgAddress><City>Rome</City>
<Country Code="IT">Italy</Country>
</OrgAddress>
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<Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading>
<AbstractSection ID="ASec1"><Heading>Purpose</Heading>
<Para TextBreak="No">In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet.</Para>
</AbstractSection>
<AbstractSection ID="ASec2"><Heading>Methods</Heading>
<Para TextBreak="No">The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions.</Para>
</AbstractSection>
<AbstractSection ID="ASec3"><Heading>Results</Heading>
<Para TextBreak="No">Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality.</Para>
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<AbstractSection ID="ASec4"><Heading>Conclusions</Heading>
<Para TextBreak="No">A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.</Para>
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<KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading>
<Keyword>Viral infection</Keyword>
<Keyword>Extracorporeal membrane oxygenation</Keyword>
<Keyword>Preparedness plan</Keyword>
<Keyword>ARDS</Keyword>
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<ArticleNote Type="Misc"><SimplePara>This article is written for the ECMOnet Italian ECMO network. Members of the network are listed in the Appendix.</SimplePara>
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<namePart type="family">Pappalardo</namePart>
<affiliation>Dipartimento di Anestesia Cardiaca e Terapia Intensiva, Università Vita-Salute San Raffaele, Milan, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Adriano</namePart>
<namePart type="family">Peris</namePart>
<affiliation>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza, Azienda Ospedaliero Universitaria Careggi, Florence, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giovanni</namePart>
<namePart type="family">Cianchi</namePart>
<affiliation>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza, Azienda Ospedaliero Universitaria Careggi, Florence, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonio</namePart>
<namePart type="family">Braschi</namePart>
<affiliation>Dipartimento di Scienze Chirurgiche Rianimatorie-Riabilitative e dei Trapianti d’Organo, Sezione di Anestesia Rianimazione e Terapia Antalgica, Anestesia e Rianimazione I Dipartimento di Emergenza Urgenza, Università degli Studi di Pavia, IRCCS Policlinico San Matteo, Pavia, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giorgio</namePart>
<namePart type="given">A.</namePart>
<namePart type="family">Iotti</namePart>
<affiliation>Anestesia e Rianimazione II, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonio</namePart>
<namePart type="family">Arcadipane</namePart>
<affiliation>Terapia Intensiva, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione, Palermo, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giovanna</namePart>
<namePart type="family">Panarello</namePart>
<affiliation>Terapia Intensiva, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione, Palermo, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">V.</namePart>
<namePart type="given">Marco</namePart>
<namePart type="family">Ranieri</namePart>
<affiliation>Dipartimento di Anestesiologia e Medicina degli Stati Critici, Università di Torino, Ospedale S. Giovanni Battista-Molinette, Turin, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Pierpaolo</namePart>
<namePart type="family">Terragni</namePart>
<affiliation>Dipartimento di Anestesiologia e Medicina degli Stati Critici, Università di Torino, Ospedale S. Giovanni Battista-Molinette, Turin, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Massimo</namePart>
<namePart type="family">Antonelli</namePart>
<affiliation>Dipartimento di Terapia Intensiva e Anestesiologia, Università Cattolica del Sacro Cuore, Rome, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Luciano</namePart>
<namePart type="family">Gattinoni</namePart>
<affiliation>Dipartimento di Anestesiologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Fabrizio</namePart>
<namePart type="family">Oleari</namePart>
<affiliation>Dipartimento della Prevenzione e Comunicazione, Ministero della Salute, Rome, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonio</namePart>
<namePart type="family">Pesenti</namePart>
<affiliation>Department of Experimental Medicine, University of Milan-Bicocca, Via Pergolesi 33, 20052, Monza, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
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<place><placeTerm type="text">Berlin/Heidelberg</placeTerm>
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<dateCreated encoding="w3cdtf">2011-03-02</dateCreated>
<dateIssued encoding="w3cdtf">2011-09-01</dateIssued>
<copyrightDate encoding="w3cdtf">2011</copyrightDate>
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<abstract lang="en">Abstract: Purpose: In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet. Methods: The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions. Results: Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality. Conclusions: A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.</abstract>
<note>Original</note>
<subject lang="en"><genre>Keywords</genre>
<topic>Viral infection</topic>
<topic>Extracorporeal membrane oxygenation</topic>
<topic>Preparedness plan</topic>
<topic>ARDS</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Intensive Care Medicine</title>
</titleInfo>
<titleInfo type="abbreviated"><title>Intensive Care Med</title>
</titleInfo>
<genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre>
<originInfo><publisher>Springer</publisher>
<dateIssued encoding="w3cdtf">2011-08-13</dateIssued>
<copyrightDate encoding="w3cdtf">2011</copyrightDate>
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<subject><genre>Medicine & Public Health</genre>
<topic>Pain Medicine</topic>
<topic>Anesthesiology</topic>
<topic>Intensive / Critical Care Medicine</topic>
<topic>Pediatrics</topic>
<topic>Pneumology/Respiratory System</topic>
<topic>Emergency Medicine</topic>
</subject>
<identifier type="ISSN">0342-4642</identifier>
<identifier type="eISSN">1432-1238</identifier>
<identifier type="JournalID">134</identifier>
<identifier type="IssueArticleCount">31</identifier>
<identifier type="VolumeIssueCount">12</identifier>
<part><date>2011</date>
<detail type="volume"><number>37</number>
<caption>vol.</caption>
</detail>
<detail type="issue"><number>9</number>
<caption>no.</caption>
</detail>
<extent unit="pages"><start>1447</start>
<end>1457</end>
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<identifier type="istex">953DF1A32E5323ABDD176BA1641D15EDCC465556</identifier>
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<identifier type="DOI">10.1007/s00134-011-2301-6</identifier>
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<identifier type="ArticleID">s00134-011-2301-6</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright jointly held by Springer and ESICM, 2011</accessCondition>
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