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Referral for ECMO during H1N1 in the UK Mr Chris Harvey Locum Consultant in Adult and Paediatric ECMO Glenfield Hospital, Leicester UK.

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Presentation on theme: "Referral for ECMO during H1N1 in the UK Mr Chris Harvey Locum Consultant in Adult and Paediatric ECMO Glenfield Hospital, Leicester UK."— Presentation transcript:

1 Referral for ECMO during H1N1 in the UK Mr Chris Harvey Locum Consultant in Adult and Paediatric ECMO Glenfield Hospital, Leicester UK

2 Started as a Fairytale

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4 22 nd July 2009

5 Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome.Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators, Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N, Forrest P, Gattas D, Granger E, Herkes R, Jackson A, McGuinness S, Nair P, Pellegrino V, Pettilä V, Plunkett B, Pye R, Torzillo P, Webb S, Wilson M, Ziegenfuss M.JAMA Nov 4;302(17): Epub 2009 Oct 12.

6 Referral to an Extracorporeal Membrane Oxygenation Center and Mortality Among Patients With Severe 2009 Influenza A(H1N1) JAMA. 2011;306(15):doi: /jama Noah et al

7 Referrals - Glenfield Hospital Call Centre

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9 ECMO Patients 80 patients transferred for consideration of ECMO 69 patients received ECMO 4 Hospitals – 51 Glenfield Hospital – 18 Royal Brompton Hospital – 7 Papworth Hospital – 4 Aberdeen Royal Infirmary

10 Data collected from SwiFT Study Web based study with data collected from 192 acute hospitals throughout the UK Patients 14 th July 2009 to 19 th February 2010 ECMO Patients matched by – Individual Matching – Propensity Matching – GenMatch Matching

11 Number of days ventilated FiO2 PaO2/FiO2 ratio SOFA score Age Pregnancy BMI H1N1 Status Use of iNO, HFOV, Prone positioning Cardiac support Renal support

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15 12 by Fixed Wing 6 by Helicopter 50 by Road 6 with mobile ECMO

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22 ECMO Deaths 10 died on ECMO – 7 cerebral haemorrhage – 1 cardiac arrest – 1 progressive multi-organ failure – 1 massive pulmonary haemorrhage 6 died off ECMO 4 died after discharge to referring hospital 2 died after conventional treatment

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24 Swine Flu patients treated with ECMO survival 74% – Glenfield Hospital – Brompton Hospital – Guy’s and St Thomas’s – Papworth Hospital – Freeman Hospital – Wythenshawe Hospital – Aberdeen Royal Infirmary – Blackpool Hospital – Golden Jubilee Hospital

25 During swine flu 332 referrals

26 Any questions?


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