The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis.

Autor:	Insel M; Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona Health Sciences, Tucson, Arizona. minsel@deptofmed.arizona.edu., Natt B; Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona Health Sciences, Tucson, Arizona., Mosier J; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Arizona., Malo J; Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona Health Sciences, Tucson, Arizona., Bime C; Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona Health Sciences, Tucson, Arizona.
Jazyk:	angličtina
Zdroj:	Respiratory care [Respir Care] 2019 Mar; Vol. 64 (3), pp. 279-284. Date of Electronic Publication: 2018 Oct 30.
DOI:	10.4187/respcare.06145
Abstrakt:	Background: The 2009 H1N1 influenza epidemic saw a rise in the use of extracorporeal membrane oxygenation (ECMO) as a supportive therapy for refractory ARDS. We sought to determine whether ECMO utilization follows a seasonal pattern that matches the influenza season, and whether it can further be explained by the incidence of each influenza subtype. Methods: We performed a longitudinal analysis of non-cardiac and cardiac-associated ECMO cases from the National In-patient Sample from 2005 to 2014, using overdispersed Poisson regression to evaluate associations with influenza incidence categorized by influenza-like illness and total positive influenza tests divided by subtype from the Centers for Disease Control and Prevention. Results: Non-cardiac ECMO use was positively associated with influenza-like illness incidence in the current month (incidence risk ratio [IRR] 1.11, 95% confidence interval [CI] 1.07-1.15, P < .001) and with influenza-like illness in the previous month (IRR 1.09, 95% CI 1.05-1.14, P < .001). The 2009 H1N1 subtype had the strongest association with non-cardiac ECMO (IRR 1.19, 95% CI 1.09-1.31, P < .001). Cardiac ECMO was also positively associated with the incidence of influenza-like illness (IRR 1.05, 95% CI 1.01-1.09, P = .02). Conclusion: Non-cardiac and cardiac ECMO use in the United States were significantly associated with influenza incidence. The influenza A, H1N1 2009, subtype had the strongest association. Competing Interests: The authors have disclosed no conflicts of interest. (Copyright © 2019 by Daedalus Enterprises.)
Databáze:	MEDLINE
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