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
Autor: | Jia Shang, Linna Huang, Han Xue, Li-hua Cai, Bin Cao, Yi Yang, Hongsheng Zhao, Wei Zhang, Wenjuan Wu, Yeming Wang, Long Liu, Qingyuan Zhan, Chen Wang, Yunfu Wu, Donglin Liu, Weihua Lu |
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Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty ARDS Avian influenza A (H7N9) Complications medicine.medical_treatment Pneumonia Viral Hemorrhage 030204 cardiovascular system & hematology Influenza A Virus H7N9 Subtype Severe Acute Respiratory Syndrome lcsh:Infectious and parasitic diseases 03 medical and health sciences Plateau pressure Extracorporeal Membrane Oxygenation 0302 clinical medicine Internal medicine Influenza Human medicine Extracorporeal membrane oxygenation Animals Humans Acute respiratory distress syndrome (ARDS) lcsh:RC109-216 030212 general & internal medicine Mortality Tidal volume Retrospective Studies business.industry Pneumonia Ventilator-Associated Retrospective cohort study Middle Aged Extracorporeal membrane oxygenation (ECMO) medicine.disease Hospitals Pneumonia surgical procedures operative Infectious Diseases Barotrauma Viral pneumonia Breathing Female Partial Thromboplastin Time business Research Article |
Zdroj: | BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-10 (2018) BMC Infectious Diseases |
ISSN: | 1471-2334 |
Popis: | 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 |
Databáze: | OpenAIRE |
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