Extracorporeal lung support in H1N1 provoked acute respiratory failure: the experience of the German ARDS Network.
BACKGROUND
During the H1N1 pandemic of 2009 and 2010, the large number of patients with severe respiratory failure due to H1N1 infection strained the capacities of treatment facilities for extracorporeal membrane oxygenation (ECMO) around the world. No data on this topic have yet been published for Germany.


METHODS
During the pandemic, the German ARDS Network (a task force of the DIVI's respiratory failure section) kept track of the availability of ECMO treatment facilities with a day-to-day, Internet-based capacity assessment. In cooperation with the Robert Koch Institute, epidemiological and clinical data were obtained on all patients treated for influenza in intensive care units.


RESULTS
116 patients were identified who had H1N1 disease and were treated in the intensive care units of 9 university hospitals and 3 other maximum medical care hospitals. 61 of them received ECMO. The overall mortality was 38% (44 of 116 patients); among patients receiving ECMO, the mortality was 54% (33 of 61 patients). The mortality was higher among patients who had an accompanying malignancy or immune deficiency (72.2%).


CONCLUSIONS
Even persons without any other accompanying disease developed life-threatening respiratory failure as a result of H1N1 infection, and many of these patients needed ECMO. This study reveals for the first time that the mortality of H1N1 infection in Germany is comparable to that in other countries. H1N1 patients with acute respiratory failure had a worse outcome if they also had serious accompanying diseases.
Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin.
Steffen
S
Weber-Carstens
Anton
A
Goldmann
Michael
M
Quintel
Armin
A
Kalenka
Stefan
S
Kluge
Jürgen
J
Peters
Christian
C
Putensen
Thomas
T
Müller
Simone
S
Rosseau
Bernhard
B
Zwißler
Onnen
O
Moerer
D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D015984:Causality; D019058:Community Networks / Q000706:statistics & numerical data; D015897:Comorbidity; D015199:Extracorporeal Membrane Oxygenation / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000401:mortality* / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D058873:Pandemics / Q000517:prevention & control / Q000706:statistics & numerical data*; D015995:Prevalence; D012128:Respiratory Distress Syndrome / Q000401:mortality* / Q000628:therapy* / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome