Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration
Abstract Background Evidence concerning the efficacy and safety of extracorporeal membrane oxygenation (ECMO) in patients with influenza A (H7N9) has been was limited to case reports. Our study is aimed to investigate the current application, efficacy and safety of ECMO in for severe H7N9 pneumonia-...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-01-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-017-2903-x |
| _version_ | 1818316392747761664 |
|---|---|
| author | Linna Huang Wei Zhang Yi Yang Wenjuan Wu Weihua Lu Han Xue Hongsheng Zhao Yunfu Wu Jia Shang Lihua Cai Long Liu Donglin Liu Yeming Wang Bin Cao Qingyuan Zhan Chen Wang |
| author_facet | Linna Huang Wei Zhang Yi Yang Wenjuan Wu Weihua Lu Han Xue Hongsheng Zhao Yunfu Wu Jia Shang Lihua Cai Long Liu Donglin Liu Yeming Wang Bin Cao Qingyuan Zhan Chen Wang |
| author_sort | Linna Huang |
| collection | DOAJ |
| description | Abstract Background Evidence concerning the efficacy and safety of extracorporeal membrane oxygenation (ECMO) in patients with influenza A (H7N9) has been was limited to case reports. Our study is aimed to investigate the current application, efficacy and safety of ECMO in for severe H7N9 pneumonia-associated acute respiratory distress syndrome (ARDS) in the Chinese population. Methods A multicentre retrospective cohort study was conducted at 20 hospitals that admitted patients with avian influenza A (H7N9) viral pneumonia patients’ admission from 9 provinces in China between October 1, 2016, and March 1, 2017. Data from the National Health and Family Planning Commission of China, including general conditions, outcomes and ECMO management, were analysed. Then, successfully weaned and unsuccessfully weaned groups were compared. Results A total of 35 patients, aged 57 ± 1 years, were analysed; 65.7% of patients were male with 63% mortality. All patients underwent invasive positive pressure ventilation (IPPV), and rescue ventilation strategies were implemented for 23 cases (65.7%) with an average IPPV duration of 5 ± 1 d, PaO2/FiO2 of 78 ± 23 mmHg, tidal volume (VT) of 439 ± 61 ml and plateau pressure (Pplat) of 29 ± 8 cmH2O pre-ECMO. After 48 h on ECMO, PaO2 improved from 56 ± 21 mmHg to 90 ± 24 mmHg and PaCO2 declined from 52 ± 24 mmHg to 38 ± 24 mmHg. Haemorrhage, ventilator-associated pneumonia (VAP) and barotrauma occurred in 45.7%, 60% and 8.6% of patients, respectively. Compared with successfully weaned patients (n = 14), the 21 unsuccessfully weaned patients had a longer duration of IPPV pre-ECMO (6 ± 4 d vs. 2 ± 1 d, P < 0.01) as well as a higher Pplat (25 ± 5 cmH2O vs. 21 ± 3 cmH2O, P < 0.05) and VT (343 ± 96 ml vs. 246 ± 93 ml, P < 0.05) after 48 h on ECMO support. Furthermore, the unsuccessfully weaned group had a higher mortality (100% vs. 7.1%, P < 0.01) with more haemorrhage (77.3% vs. 28.6%, P < 0.01). Conclusions ECMO is effective at improving oxygenation and ventilation of patients with avian influenza A (H7N9) induced severe ARDS. Early initiation of ECMO with appropriate IPPV settings and anticoagulation strategies are necessary to reduce complications. |
| first_indexed | 2024-12-13T09:20:42Z |
| format | Article |
| id | doaj.art-4fedd955be4540aea39a1c780064b494 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T09:20:42Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-4fedd955be4540aea39a1c780064b4942022-12-21T23:52:44ZengBMCBMC Infectious Diseases1471-23342018-01-0118111010.1186/s12879-017-2903-xApplication of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaborationLinna Huang0Wei Zhang1Yi Yang2Wenjuan Wu3Weihua Lu4Han Xue5Hongsheng Zhao6Yunfu Wu7Jia Shang8Lihua Cai9Long Liu10Donglin Liu11Yeming Wang12Bin Cao13Qingyuan Zhan14Chen Wang15Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalThe First Affiliated Hospital of Nanchang UniversityDepartment of Critical Care Medicine, Zhongda Hospital, Southeast UniversityDepartment of Intensive Care Unit, Wuhan Medical Treatment Center HospitalDepartment of Intensive Care Unit, The First Affiliated Hospital of Wannan Medical College, Yijishan HospitalDepartment of Intensive Care Unit, Taizhou People’s HospitalDepartment of Intensive Care Unit, Affiliated Hospital of Nantong UniversityDepartment of Intensive Care Unit, Suzhou Municipal HospitalDepartment of Infectious Diseases, Henan Provincial People’s HospitalDepartment of Intensive Care Unit, Dongguan People’s HospitalDepartment of Intensive Care Unit, The First People’s Hospital of KunshanDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalDepartment of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship HospitalAbstract Background Evidence concerning the efficacy and safety of extracorporeal membrane oxygenation (ECMO) in patients with influenza A (H7N9) has been was limited to case reports. Our study is aimed to investigate the current application, efficacy and safety of ECMO in for severe H7N9 pneumonia-associated acute respiratory distress syndrome (ARDS) in the Chinese population. Methods A multicentre retrospective cohort study was conducted at 20 hospitals that admitted patients with avian influenza A (H7N9) viral pneumonia patients’ admission from 9 provinces in China between October 1, 2016, and March 1, 2017. Data from the National Health and Family Planning Commission of China, including general conditions, outcomes and ECMO management, were analysed. Then, successfully weaned and unsuccessfully weaned groups were compared. Results A total of 35 patients, aged 57 ± 1 years, were analysed; 65.7% of patients were male with 63% mortality. All patients underwent invasive positive pressure ventilation (IPPV), and rescue ventilation strategies were implemented for 23 cases (65.7%) with an average IPPV duration of 5 ± 1 d, PaO2/FiO2 of 78 ± 23 mmHg, tidal volume (VT) of 439 ± 61 ml and plateau pressure (Pplat) of 29 ± 8 cmH2O pre-ECMO. After 48 h on ECMO, PaO2 improved from 56 ± 21 mmHg to 90 ± 24 mmHg and PaCO2 declined from 52 ± 24 mmHg to 38 ± 24 mmHg. Haemorrhage, ventilator-associated pneumonia (VAP) and barotrauma occurred in 45.7%, 60% and 8.6% of patients, respectively. Compared with successfully weaned patients (n = 14), the 21 unsuccessfully weaned patients had a longer duration of IPPV pre-ECMO (6 ± 4 d vs. 2 ± 1 d, P < 0.01) as well as a higher Pplat (25 ± 5 cmH2O vs. 21 ± 3 cmH2O, P < 0.05) and VT (343 ± 96 ml vs. 246 ± 93 ml, P < 0.05) after 48 h on ECMO support. Furthermore, the unsuccessfully weaned group had a higher mortality (100% vs. 7.1%, P < 0.01) with more haemorrhage (77.3% vs. 28.6%, P < 0.01). Conclusions ECMO is effective at improving oxygenation and ventilation of patients with avian influenza A (H7N9) induced severe ARDS. Early initiation of ECMO with appropriate IPPV settings and anticoagulation strategies are necessary to reduce complications.http://link.springer.com/article/10.1186/s12879-017-2903-xExtracorporeal membrane oxygenation (ECMO)Avian influenza A (H7N9)Acute respiratory distress syndrome (ARDS)ComplicationsMortality |
| spellingShingle | Linna Huang Wei Zhang Yi Yang Wenjuan Wu Weihua Lu Han Xue Hongsheng Zhao Yunfu Wu Jia Shang Lihua Cai Long Liu Donglin Liu Yeming Wang Bin Cao Qingyuan Zhan Chen Wang Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration BMC Infectious Diseases Extracorporeal membrane oxygenation (ECMO) Avian influenza A (H7N9) Acute respiratory distress syndrome (ARDS) Complications Mortality |
| title | Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration |
| title_full | Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration |
| title_fullStr | Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration |
| title_full_unstemmed | Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration |
| title_short | Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration |
| title_sort | application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza a h7n9 viral pneumonia national data from the chinese multicentre collaboration |
| topic | Extracorporeal membrane oxygenation (ECMO) Avian influenza A (H7N9) Acute respiratory distress syndrome (ARDS) Complications Mortality |
| url | http://link.springer.com/article/10.1186/s12879-017-2903-x |
| work_keys_str_mv | AT linnahuang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT weizhang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT yiyang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT wenjuanwu applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT weihualu applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT hanxue applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT hongshengzhao applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT yunfuwu applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT jiashang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT lihuacai applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT longliu applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT donglinliu applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT yemingwang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT bincao applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT qingyuanzhan applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration AT chenwang applicationofextracorporealmembraneoxygenationinpatientswithsevereacuterespiratorydistresssyndromeinducedbyavianinfluenzaah7n9viralpneumonianationaldatafromthechinesemulticentrecollaboration |