@article {Turner941, author = {David A Turner and Kyle J Rehder and Stacey L Peterson-Carmichael and Caroline P Ozment and Mashael S Al-Hegelan and Walter L Williford and Michelle A Peters and Paul W Noble and Ira M Cheifetz}, title = {Extracorporeal Membrane Oxygenation for Severe Refractory Respiratory Failure Secondary to 2009 H1N1 Influenza A}, volume = {56}, number = {7}, pages = {941--946}, year = {2011}, doi = {10.4187/respcare.01066}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Respiratory failure and acute respiratory distress syndrome secondary to H1N1 influenza infection is a source of substantial morbidity and mortality, having caused over 265,000 hospitalizations in the United States in 2009. During the H1N1 pandemic, up to 31\% of the H1N1 patients required intensive care unit admission, and many were refractory to maximal conventional therapies. These most critically ill patients may require extracorporeal membrane oxygenation (ECMO) for survival. METHODS: We retrospectively reviewed the medical records of the 7 patients with refractory hypoxemia due to H1N1 influenza who were treated with ECMO in our pediatric intensive care unit. RESULTS: Five of the 7 patients survived to hospital discharge. The cohort{\textquoteright}s mean age was 21 years, and 4 were female. At admission to the pediatric intensive care unit, 6 had at least one comorbid condition, 6 were mechanically ventilated, and one was in shock. All 7 patients were treated with oral oseltamivir, high-frequency oscillatory ventilation, and inhaled nitric oxide prior to ECMO. Five received intravenous steroids, and 2 were treated with compassionate-use intravenous zanamivir. The mean duration of pre-ECMO ventilation was 8.7 days (range 14 h to 25 d). Mean oxygenation index was 50 (range 26{\textendash}73) at ECMO cannulation. Six received venovenous ECMO, and one received venoarterial ECMO. The mean duration of ECMO was 432 hours (range 192{\textendash}890 h). CONCLUSIONS: This series suggests that ECMO is a viable treatment for refractory hypoxemia secondary to H1N1 influenza infection in both pediatric and adult patients.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/56/7/941}, eprint = {https://rc.rcjournal.com/content/56/7/941.full.pdf}, journal = {Respiratory Care} }