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
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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