0
Editorials: POINT/COUNTERPOINT EDITORIALS |

Counterpoint: Efficacy of Extracorporeal Membrane Oxygenation in 2009 Influenza A(H1N1): Sufficient Evidence?

Alan H. Morris, MD, FCCP; Eliotte Hirshberg, MD; Russell R. Miller, III, MD; Kimberly D. Statler, MD; R. Duncan Hite, MD, FCCP
Author and Funding Information

From the Intermountain Medical Center (Drs Morris, Hirshberg and Miller); the Health Sciences Center, University of Utah (Drs Hirshberg and Statler); and the Wake Forest University School of Medicine (Dr Hite).

Correspondence to: Alan H. Morris, MD, Sorenson Heart-Lung Center-6th Floor, 5121 South Cottonwood St, Murray, UT 84157-7000; e-mail: alan.morris@imail.org


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Morris received grant monies from Agency for Health Care Policy and Research for the initial work. Dr Hite is a shareholder of Discover Laboratories and a member of the Data Safety and Monitoring Board, Cumberland Pharmaceuticals, 2006 to present. Drs Hirshberg, Miller, and Statler have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(4):778-781. doi:10.1378/chest.10-1792
Text Size: A A A
Published online

Extract

Extracorporeal life support (ECLS) (including extracorporeal membrane oxygenation [ECMO] and extracorporeal CO2 removal) can be used in patients with inadequate oxygen delivery, including ineffective oxygenation due to severe lung disease. The current 2009 influenza A(H1N1) [A(H1N1)] epidemic has promoted ECMO use2 due to the severe hypoxemia witnessed in several populations.2-7 Although not formally recommended, ECMO has been included among the “salvage therapies” listed on an important Web site (http://www.thoracic.org/clinical/critical-care/salvage-therapies-h1n1/pages/ecmo.php). There are conflicting results regarding efficacy of ECMO in hypoxemic lung failure in adults8-10 with commentaries reflecting different interpretations of the clinical trials.11-14 Support with ECMO is hazardous5 and more costly than mechanical ventilation support.9 Risks include bleeding, activation of complement, and the threats of air embolism, vascular damage, and infection. Thus, ECMO treatment of hypoxemic lung failure demands critical evaluation. We focus herein on the following question: Is ECLS useful in critically ill adults with ARDS following novel A(H1N1) influenza infection?

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543