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

4. 22nd 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)
Noah et al
JAMA. 2011;306(15):doi: /jama

7. Referrals - Glenfield Hospital Call Centre

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 14th July 2009 to 19th February 2010
ECMO Patients matched by
Individual Matching
Propensity Matching
GenMatch Matching

11. Use of iNO, HFOV, Prone positioning Cardiac support Renal support
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

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

22. ECMO Deaths 10 died on ECMO 6 died off 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

24. Swine Flu 2010-2011 87 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?