Successful use of extracorporeal membrane oxygenation for pH1N1-induced refractory hypoxemia in a child with hypoplastic left heart syndrome.
OBJECTIVE
To report the first successful use of extracorporeal membrane oxygenation for acute respiratory distress syndrome secondary to 2009 pH1N1 influenza A infection in a child status post the Fontan operation for hypoplastic left heart syndrome.


METHODS
Individual case report.


METHODS
Pediatric intensive care unit.


METHODS
We describe a 7-yr-old boy with a history of the Fontan operation for hypoplastic left heart syndrome admitted with acute respiratory distress syndrome secondary to 2009 pH1N1 influenza A infection.


METHODS
Cannulation for venoarterial extracorporeal membrane oxygenation.


RESULTS
In this patient with a history of complex congenital heart disease and repair, extracorporeal membrane oxygenation was a successful rescue therapy for refractory pH1N1-induced respiratory failure.


CONCLUSIONS
Extracorporeal membrane oxygenation can be successfully applied for refractory respiratory failure, even in the setting of significant underlying comorbidity. With emerging data to support the role of extracorporeal membrane oxygenation in improving mortality for refractory hypoxemia secondary to pH1N1, it is prudent to strongly consider the use of extracorporeal support in patients with underlying diseases or comorbidities that may have previously precluded them from being candidates for this therapy.
Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, NC, USA. niyati.gandhi@duke.edu
Niyati N
NN
Gandhi
Mary E
ME
Hartman
Walter L
WL
Williford
Michelle A
MA
Peters
Ira M
IM
Cheifetz
David A
DA
Turner
D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000592:standards*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome; D000860:Hypoxia / Q000209:etiology*; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000821:virology; D015278:Intensive Care Units, Pediatric; D008297:Male; D009657:North Carolina; D012128:Respiratory Distress Syndrome