Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic.
OBJECTIVE
We report the process used to rapidly develop a collaborative adult respiratory extracorporeal membrane oxygenation program as a response to caring for young adult patients with refractory hypoxemia in the setting of the pH1N1 pandemic.


METHODS
Interdisciplinary response of a complex medical system to a public health crisis. PATIENTS, INTERVENTIONS, MEASUREMENTS, AND MAIN RESULTS: After the successful use of extracorporeal membrane oxygenation in young adults with pH1N1-induced acute respiratory distress syndrome refractory to conventional therapies, an adult venovenous extracorporeal membrane oxygenation program was implemented over an 8-wk period. Implementation of this program involved a number of key steps that were crucial in the development process, including administrative and institutional support, multidisciplinary leadership and collaboration, extensive interdisciplinary educational initiatives, and substantial technical modifications.


CONCLUSIONS
In the setting of the pH1N1 influenza pandemic, an adult respiratory extracorporeal membrane oxygenation program was successfully developed to complement an established neonatal-pediatric program. This program expansion integrated all of the necessary components involved in the development process from start to finish and confirms that a healthcare system can respond very quickly and successfully to an urgent healthcare need.
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, NC, USA. David.Turner@Duke.edu
David A
DA
Turner
Walter L
WL
Williford
Michelle A
MA
Peters
Janice J
JJ
Thalman
Ian R
IR
Shearer
Richard J
RJ
Walczak
Michael
M
Griffis
Steven A
SA
Olson
Kevin W
KW
Sowers
Joseph A
JA
Govert
Neil R
NR
Macintyre
Ira M
IM
Cheifetz
D000328:Adult; D003299:Cooperative Behavior; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy*; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology; D058873:Pandemics; D016730:Program Development / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy* / Q000821:virology; D055815:Young Adult