title: Three-year experience of using venovenous extracorporeal membrane oxygenation for patients with severe respiratory failure.
abstract: OBJECTIVE
  To present the 3-year experience of using venovenous extracorporeal membrane oxygenation for patients with severe respiratory failure in a single centre in Hong Kong.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A 19-bed Intensive Care Unit of a tertiary hospital in Hong Kong.
  
  
  METHODS
  All patients who were managed with venovenous extracorporeal membrane oxygenation from 1 July 2010 to 30 June 2013 in the Intensive Care Unit.
  
  
  RESULTS
  Overall, 31 patients (mean age, 42.2 years, standard deviation, 14.1 years; 21 males) received venovenous extracorporeal membrane oxygenation for the treatment of severe respiratory failure. Of these, 90.3% (28 patients) presented with pneumonia as the cause of the respiratory failure, and 22 of them had identifiable causes. A total of nine (29.0%) patients were diagnosed to have H1N1 infection. The median Murray score was 3.5 (interquartile range, 3.0-3.5); the median duration of venovenous extracorporeal membrane oxygenation support was 5.0 (2.8-8.6) days; and the median duration of mechanical ventilator support was 18.2 (7.8-27.9) days. The overall intensive care unit mortality was 19.4% (n=6). The overall in-hospital mortality and the 28-day mortality were both 22.6% (n=7). Among the 22 patients who had identifiable infective causes, those suffering from viral infection had lower intensive care unit and hospital mortality than those who had bacterial infection (8.3% vs 20.0%). All the H1N1 patients survived. Complications related to extracorporeal membrane oxygenation included severe bleeding (n=2; 6.5%) and mechanical complications of the circuits (n=3; 9.7%).
  
  
  CONCLUSIONS
  Venovenous extracorporeal membrane oxygenation is an effective adjunctive therapy and can be used as a life-saving procedure for carefully selected patients with severe acute respiratory distress syndrome when the limits of standard therapy have been reached.
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: George W Y
authors.initials: GW
authors.lastname: Ng
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: Anne K H
authors.initials: AK
authors.lastname: Leung
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: K C
authors.initials: KC
authors.lastname: Sin
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: S Y
authors.initials: SY
authors.lastname: Au
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: Stanley C H
authors.initials: SC
authors.lastname: Chan
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: Osburga P K
authors.initials: OP
authors.lastname: Chan
authors.affiliation: Department of Intensive Care, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
authors.forename: Helen H L
authors.initials: HH
authors.lastname: Wu
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006723:Hong Kong; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000401:mortality / Q000628:therapy; D007362:Intensive Care Units; D008297:Male; D011024:Pneumonia, Viral / Q000401:mortality / Q000628:therapy; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
keywords: Extracorporeal membrane oxygenation; Intensive care units; Respiratory insufficiency