The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks
Identifieur interne : 002204 ( Main/Exploration ); précédent : 002203; suivant : 002205The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks
Auteurs : Nicol Patroniti [Italie] ; Alberto Zangrillo [Italie] ; Federico Pappalardo [Italie] ; Adriano Peris [Italie] ; Giovanni Cianchi [Italie] ; Antonio Braschi [Italie] ; Giorgio A. Iotti [Italie] ; Antonio Arcadipane [Italie] ; Giovanna Panarello [Italie] ; V. Marco Ranieri [Italie] ; Pierpaolo Terragni [Italie] ; Massimo Antonelli [Italie] ; Luciano Gattinoni [Italie] ; Fabrizio Oleari [Italie] ; Antonio Pesenti [Italie]Source :
- 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.
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DOI: 10.1007/s00134-011-2301-6
Affiliations:
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Nicol" uniqKey="Patroniti N" first="Nicol" last="Patroniti">Nicol Patroniti</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Experimental Medicine, University of Milan-Bicocca, Via Pergolesi 33, 20052, Monza</wicri:regionArea><wicri:noRegion>Monza</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, 20052, Monza</wicri:regionArea><wicri:noRegion>Monza</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Italie</country></affiliation></author><author><name sortKey="Zangrillo, Alberto" sort="Zangrillo, Alberto" uniqKey="Zangrillo A" first="Alberto" last="Zangrillo">Alberto Zangrillo</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Anestesia Cardiaca e Terapia Intensiva, Università Vita-Salute San Raffaele, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pappalardo, Federico" sort="Pappalardo, Federico" uniqKey="Pappalardo F" first="Federico" last="Pappalardo">Federico Pappalardo</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Anestesia Cardiaca e Terapia Intensiva, Università Vita-Salute San Raffaele, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Peris, Adriano" sort="Peris, Adriano" uniqKey="Peris A" first="Adriano" last="Peris">Adriano Peris</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza, Azienda Ospedaliero Universitaria Careggi, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Cianchi, Giovanni" sort="Cianchi, Giovanni" uniqKey="Cianchi G" first="Giovanni" last="Cianchi">Giovanni Cianchi</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’Urgenza, Azienda Ospedaliero Universitaria Careggi, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Braschi, Antonio" sort="Braschi, Antonio" uniqKey="Braschi A" first="Antonio" last="Braschi">Antonio Braschi</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>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</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Iotti, Giorgio A" sort="Iotti, Giorgio A" uniqKey="Iotti G" first="Giorgio A." last="Iotti">Giorgio A. Iotti</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Anestesia e Rianimazione II, Fondazione IRCCS Policlinico San Matteo, Pavia</wicri:regionArea><wicri:noRegion>Pavia</wicri:noRegion></affiliation></author><author><name sortKey="Arcadipane, Antonio" sort="Arcadipane, Antonio" uniqKey="Arcadipane A" first="Antonio" last="Arcadipane">Antonio Arcadipane</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Terapia Intensiva, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione, Palermo</wicri:regionArea><wicri:noRegion>Palermo</wicri:noRegion></affiliation></author><author><name sortKey="Panarello, Giovanna" sort="Panarello, Giovanna" uniqKey="Panarello G" first="Giovanna" last="Panarello">Giovanna Panarello</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Terapia Intensiva, Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione, Palermo</wicri:regionArea><wicri:noRegion>Palermo</wicri:noRegion></affiliation></author><author><name sortKey="Ranieri, V Marco" sort="Ranieri, V Marco" uniqKey="Ranieri V" first="V. Marco" last="Ranieri">V. Marco Ranieri</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Anestesiologia e Medicina degli Stati Critici, Università di Torino, Ospedale S. Giovanni Battista-Molinette, Turin</wicri:regionArea><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Terragni, Pierpaolo" sort="Terragni, Pierpaolo" uniqKey="Terragni P" first="Pierpaolo" last="Terragni">Pierpaolo Terragni</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Anestesiologia e Medicina degli Stati Critici, Università di Torino, Ospedale S. Giovanni Battista-Molinette, Turin</wicri:regionArea><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Terapia Intensiva e Anestesiologia, Università Cattolica del Sacro Cuore, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Gattinoni, Luciano" sort="Gattinoni, Luciano" uniqKey="Gattinoni L" first="Luciano" last="Gattinoni">Luciano Gattinoni</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento di Anestesiologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Oleari, Fabrizio" sort="Oleari, Fabrizio" uniqKey="Oleari F" first="Fabrizio" last="Oleari">Fabrizio Oleari</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento della Prevenzione e Comunicazione, Ministero della Salute, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pesenti, Antonio" sort="Pesenti, Antonio" uniqKey="Pesenti A" first="Antonio" last="Pesenti">Antonio Pesenti</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Experimental Medicine, University of Milan-Bicocca, Via Pergolesi 33, 20052, Monza</wicri:regionArea><wicri:noRegion>Monza</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2011-09-01">2011-09-01</date><biblScope unit="volume">37</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1447">1447</biblScope><biblScope unit="page" to="1457">1457</biblScope></imprint><idno type="ISSN">0342-4642</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0342-4642</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ARDS</term><term>Extracorporeal membrane oxygenation</term><term>Preparedness plan</term><term>Viral infection</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><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></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li><li>Lombardie</li><li>Piémont</li></region><settlement><li>Milan</li><li>Rome</li><li>Turin</li></settlement></list><tree><country name="Italie"><noRegion><name sortKey="Patroniti, Nicol" sort="Patroniti, Nicol" uniqKey="Patroniti N" first="Nicol" last="Patroniti">Nicol Patroniti</name></noRegion><name sortKey="Antonelli, Massimo" sort="Antonelli, Massimo" uniqKey="Antonelli M" first="Massimo" last="Antonelli">Massimo Antonelli</name><name sortKey="Arcadipane, Antonio" sort="Arcadipane, Antonio" uniqKey="Arcadipane A" first="Antonio" last="Arcadipane">Antonio Arcadipane</name><name sortKey="Braschi, Antonio" sort="Braschi, Antonio" uniqKey="Braschi A" first="Antonio" last="Braschi">Antonio Braschi</name><name sortKey="Cianchi, Giovanni" sort="Cianchi, Giovanni" uniqKey="Cianchi G" first="Giovanni" last="Cianchi">Giovanni Cianchi</name><name sortKey="Gattinoni, Luciano" sort="Gattinoni, Luciano" uniqKey="Gattinoni L" first="Luciano" last="Gattinoni">Luciano Gattinoni</name><name sortKey="Iotti, Giorgio A" sort="Iotti, Giorgio A" uniqKey="Iotti G" first="Giorgio A." last="Iotti">Giorgio A. Iotti</name><name sortKey="Oleari, Fabrizio" sort="Oleari, Fabrizio" uniqKey="Oleari F" first="Fabrizio" last="Oleari">Fabrizio Oleari</name><name sortKey="Panarello, Giovanna" sort="Panarello, Giovanna" uniqKey="Panarello G" first="Giovanna" last="Panarello">Giovanna Panarello</name><name sortKey="Pappalardo, Federico" sort="Pappalardo, Federico" uniqKey="Pappalardo F" first="Federico" last="Pappalardo">Federico Pappalardo</name><name sortKey="Patroniti, Nicol" sort="Patroniti, Nicol" uniqKey="Patroniti N" first="Nicol" last="Patroniti">Nicol Patroniti</name><name sortKey="Patroniti, Nicol" sort="Patroniti, Nicol" uniqKey="Patroniti N" first="Nicol" last="Patroniti">Nicol Patroniti</name><name sortKey="Peris, Adriano" sort="Peris, Adriano" uniqKey="Peris A" first="Adriano" last="Peris">Adriano Peris</name><name sortKey="Pesenti, Antonio" sort="Pesenti, Antonio" uniqKey="Pesenti A" first="Antonio" last="Pesenti">Antonio Pesenti</name><name sortKey="Ranieri, V Marco" sort="Ranieri, V Marco" uniqKey="Ranieri V" first="V. Marco" last="Ranieri">V. Marco Ranieri</name><name sortKey="Terragni, Pierpaolo" sort="Terragni, Pierpaolo" uniqKey="Terragni P" first="Pierpaolo" last="Terragni">Pierpaolo Terragni</name><name sortKey="Zangrillo, Alberto" sort="Zangrillo, Alberto" uniqKey="Zangrillo A" first="Alberto" last="Zangrillo">Alberto Zangrillo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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