title: A[H1N1] flu and refractory hypoxaemia: is extracorporeal lung support the holy grail?
abstract: There is a call for methodologically robust randomised clinical trials in adult extracorporeal membrane oxygenation for its routine implementation for patients with "failing" conventional ventilation. Adherence to lung protective ventilation strategies, along with fluid balance [if required early renal replacement therapy] and inotropes to support the circulation to minimise ventilator-induced lung injury, may mitigate deterioration requiring extracorporeal lung support. Currently there is no convincing evidence to routinely advocate extracorporeal lung support in failed conventional ventilation, and a prospective trial is needed to define standard best practice and to tailor extracorporeal lung support referral criteria in young patient cohort with severe refractory respiratory failure.
authors.affiliation: John Farman Intensive Care Unit, Addenbrooke's Hospital, Cambridge University Hospital NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: T V
authors.initials: TV
authors.lastname: Veenith
authors.forename: M
authors.initials: M
authors.lastname: Rana
authors.forename: A
authors.initials: A
authors.lastname: Ercole
authors.forename: K
authors.initials: K
authors.lastname: Gunning
authors.forename: R
authors.initials: R
authors.lastname: Mahroof
mesh_terms: D000293:Adolescent; D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000860:Hypoxia / Q000150:complications* / Q000821:virology; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult