Re: Netherlands: new method saves lives of 2 H1N1 patients
AZ Maastricht saves lives flu patients with new treatment
5.28 A new method has saved the lives of two patients with the H1N1 flu at the Academic Hospital Maastricht (AZM).
The patients underwent extracorporeal membrane oxygenation ECMO ie through a single catheter in a jugular vein.
That means that an artificial lung directly pumps oxygen into the blood so that vital organs are given time to recover.
The first patient could not be ventilated in a normal way. By ECMO for three weeks to apply, could eventually be cured of a severe lung inflammation.
Medication and mechanical ventilation in turn made sure that the patient could recover. When illness or injury to heart and / or lungs under control, the organs can take over the work again.
It may be several months before the patient has completely recovered.
The treatment according to the azM was successfully appliedtwo times.
http://www.gva.be/nieuws/wetenschap...se-grieppatienten-met-nieuwe-behandeling.aspx
Some background on ECMO:
Extracorporeal membrane oxygenation for severe acute respiratory failure
Critical Care 2000, 4:156-168doi:10.1186/cc689
The electronic version of this article is the complete one and can be found online at:
http://ccofrum.com/content/4/3/156
Published: 12 April 2000
Abstract
Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems.
ECMO technique was an adaptation of conventional cardiopulmonary bypass technique and introduced into treatment of severe acute respiratory distress syndrome (ARDS) in the 1970s.
The intial reports of the use of ECMO in ARDS patients were quite enthusiastic, however, in the following years it became clear that ECMO was only of benefit in newborns with acute respiratory failure. In neonates treated with ECMO, survival rates of 80% could be achieved. In adult patients with ARDS, two large randomized controlled trials (RCTs) published in 1979 and 1994 failed to show an advantage of ECMO over convential treatment, survival rates were only 10% and 33%, respectively, in the ECMO groups.
Since then, ECMO technology as well as conventional treatment of adult ARDS have undergone further improvements. In conventional treatment lung-protective ventilation strategies were introduced and ECMO was made safer by applying heparin-coated equipment, membranes and tubings.
Many ECMO centres now use these advanced ECMO technology and report survival rates in excess of 50% in uncontrolled data collections. The question, however, of whether the improved ECMO can really challenge the advanced conventional treatment of adult ARDS is unanswered and will need evaluation by a future RCT.
more:
http://ccforum.com/content/4/3/156
