Volume 15, Number 12—December 2009
Extracorporeal Membrane Oxygenation for Pandemic (H1N1) 2009
|Cardiac support (1)|
|Cardiac index <2.2 L/min/m2|
|Systolic pressure <90 mm Hg|
|Pulmonary capillary wedge pressure >20 mm Hg|
|Central venous pressure >20 mm Hg|
|Two high-dose inotropic medications (Including intraaortic counter pulsation)
|Respiratory support (2)|
|Murray score >3.0 based on:|
|No. infiltrated quadrants on chest radiograph|
|Positive end-expiratory pressure requirement|
|Uncompensated hypercapnea (pH<7.2)
|Advancing age (>70 y)|
|Prolonged mechanical ventilation (>7 d)|
|Surgically correctable causes|
|Pneumothorax, effusions, endoluminal obstructions|
|Intracardiac shunts, valvular pathology, incomplete revascularization|
|Medical problems incompatible with prolonged survival|
|Contraindications to anticoagulation|
|Irreversible neurologic dysfunction (dementia, stroke, hemorrhage)|
|Medical futility (i.e., prolonged CPR, multiorgan failure)|
*CPR, cardiopulmonary resuscitation; PaO2, partial pressure of oxygen in arterial blood; F1O2, concentration of inspired oxygen.
- Samuels LE, Kaufman MS, Thomas MP, Holmes EC, Brockman SK, Wechsler AS. Pharmacological criteria for ventricular assist device insertion following postcardiotomy shock: experience with the ABIOMED BVS system. J Card Surg. 1999;14:288–93.
- Thalanany MM, Mugford M, Hibbert C, Cooper NJ, Truesdale A, Robinson S, ; CESAR Trial Group. Methods of data collection and analysis for the economic evaluation alongside a national, multi-centre trial in the UK: conventional ventilation or ECMO for severe adult respiratory failure (CESAR). BMC Health Serv Res. 2008;8:94.
- Extracorporeal life support: the University of Michigan experience. JAMA. 2000;283:904–8.Bartlett RHRoloff DWCuster JRYounger JGHirschl RB
- Lefrak EA, Steven PM, Pitha J, Balsinger E, Noon GP, Mayor HD. Extracorporeal membrane oxygenation for fulminary influenza pneumonia. Chest. 1974;66:385–8.
- Centers for Disease Control and Prevention. Intensive-care patients with severe novel influenza A (H1N1) virus infection—Michigan, June 2009. MMWR Morb Mortal Wkly Rep. 2009;58:749–52.
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