October 6 – Patients critically ill from swine flu infection enjoyed a doubled survival chance if they were treated at centres with high-tech oxygen-boosting systems, British researchers have reported. The study suggests massive benefits from the use of extra-corporeal membrane oxygenation (ECMO) – which adds oxygen to blood circulated externally from the patient.
Britain has four ECMO centres for adults and some 69 swine flu patients were transferred to them during the outbreak in the winter of 2009 to 2010. ECMO is at least twice as expensive as conventional ventilation.
The research, conducted by surgeon Moronke Noah, of Glenfield Hospital, Leicester, showed that 22 of these patients died. This compared with about 50 per cent of similar patients who did not get the treatment.
The findings are being reported to the conference of the European Society of Intensive Care Medicine in Berlin, Germany, and are also reported in the Journal of the American Medical Association.
The researchers sought to match patients who received ECMO carefully with other patients with similar circumstances.
The researchers write: “The role of ECMO in acute respiratory distress syndrome is debated. Several reports and our study demonstrate that ECMO can be undertaken without the prohibitive morbidity and adverse events seen in the 1970s.”
Writing in the journal Dr William Checkley, of Johns Hopkins University, Baltimore, USA, says the research “revitalises” interest in the use of ECMO for treating critical lung disease.
He writes: “While underlying risk factors may be different, severe respiratory failure from H1N1 infection presents a clinical challenge similar to that involving acute respiratory distress syndrome from other causes. ”