Despite the severity of disease and the intensity of treatment, most patients in Australia and New Zealand who experienced respiratory failure as a result of 2009 influenza A(H1N1) and were treated with a system that adds oxygen to the patient’s blood survived the disease, according to a study to appear in the November 4 issue of JAMA. This study is being published early online because of its public health importance.
The influenza A(H1N1) pandemic affected Australia and New Zealand during the 2009 southern hemisphere winter, causing an epidemic of critical illness. Some patients developed severe acute respiratory distress syndrome (ARDS) and were treated with extracorporeal membrane oxygenation (ECMO), according to background information in the article.
The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators in collaboration with the Australian and New Zealand Intensive Care Research Centre at Monash University in Melbourne, conducted an observational study of patients with 2009 influenza A(H1N1)-associated ARDS treated with ECMO in 15 intensive care units (ICUs) in Australia and New Zealand between June 1 and August 31, 2009. The researchers looked at incidence, clinical features, the degree of lung dysfunction, technical characteristics, the duration of ECMO, complications, and survival.
“Affected patients were often young adults, pregnant or postpartum, obese, had severe respiratory failure before ECMO, and received prolonged mechanical ventilation and ECMO support,” the authors write.
“Despite their illness severity and the prolonged use of life support, most of these patients survived,” the authors conclude. “This information should facilitate health care planning and clinical management for these complex patients during the ongoing pandemic.”