title: [Extracorporeal lung support in patients with severe respiratory failure secondary to the 2010-2011 winter seasonal outbreak of influenza A (H1N1) in Spain].
abstract: OBJECTIVE
  To describe the use of extracorporeal membrane oxygenation (ECMO) in refractory respiratory failure.
  
  
  METHODS
  A prospective, observational, multi-center study was carried out.
  
  
  METHODS
  Intensive Care Units (ICU) in 148 Spanish hospitals.
  
  
  METHODS
  Subjects admitted during epidemic weeks 50-52 of 2010 and weeks 1-4 of 2011, receiving respiratory support with ECMO.
  
  
  METHODS
  Clinical and blood gas features, complications and survival of patients with ECMO.
  
  
  RESULTS
  Out of 300 ICU admitted patients, 239 (79.6%) were mechanically ventilated. ECMO was available in only 5 ICUs. Nine patients were treated with ECMO (3% of the total and 3.2% of the ventilated patients). In 77.7% of the cases some hypoxemia rescue technique was previously used. ECMO was initiated when ARDS proved refractory to standard treatment. ECMO therapy was started a median of 4.5 days after the onset of mechanical ventilation. The median duration of ECMO was 6 days. Veno-venous (VV) ECMO was the most frequent cannulation mode (88.9%). Four patients had complications associated with ECMO therapy. The median ICU and hospital stay was 17 and 29 days, respectively. In five patients (55.5%), ECMO assistance was satisfactory suspended. The ICU and hospital survival rate was 44.4%.
  
  
  CONCLUSIONS
  The use of ECMO in refractory respiratory failure in patients with influenza A (H1N1) is rare in Spain. The hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.
authors.affiliation: Servicio Medicina Intensiva, Hospital Universitario y Politécnico La Fe, CIBER Enfermedades Respiratorias, Valencia, España. jbonastremora@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Bonastre
authors.forename: B
authors.initials: B
authors.lastname: Suberviola
authors.forename: J C
authors.initials: JC
authors.lastname: Pozo
authors.forename: J E
authors.initials: JE
authors.lastname: Guerrero
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez
authors.forename: I
authors.initials: I
authors.lastname: Martín-Loeches
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D053139:Oseltamivir / Q000627:therapeutic use; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012621:Seasons; D012772:Shock, Septic / Q000209:etiology / Q000401:mortality; D013030:Spain / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir