Intensive Care Medicine

, 37:1447

The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks

  • Nicolò Patroniti
  • Alberto Zangrillo
  • Federico Pappalardo
  • Adriano Peris
  • Giovanni Cianchi
  • Antonio Braschi
  • Giorgio A. Iotti
  • Antonio Arcadipane
  • Giovanna Panarello
  • V. Marco Ranieri
  • Pierpaolo Terragni
  • Massimo Antonelli
  • Luciano Gattinoni
  • Fabrizio Oleari
  • Antonio Pesenti
Original

DOI: 10.1007/s00134-011-2301-6

Cite this article as:
Patroniti, N., Zangrillo, A., Pappalardo, F. et al. Intensive Care Med (2011) 37: 1447. doi:10.1007/s00134-011-2301-6

Abstract

Purpose

In view of the expected 2009 influenza A(H1N1) pandemic, the Italian Health Authorities set up a national referral network of selected intensive care units (ICU) able to provide advanced respiratory care up to extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS). We describe the organization and results of the network, known as ECMOnet.

Methods

The network consisted of 14 ICUs with ECMO capability and a national call center. The network was set up to centralize all severe patients to the ECMOnet centers assuring safe transfer. An ad hoc committee defined criteria for both patient transfer and ECMO institutions.

Results

Between August 2009 and March 2010, 153 critically ill patients (53% referred from other hospitals) were admitted to the ECMOnet ICU with suspected H1N1. Sixty patients (48 of the referred patients, 49 with confirmed H1N1 diagnosis) received ECMO according to ECMOnet criteria. All referred patients were successfully transferred to the ECMOnet centers; 28 were transferred while on ECMO. Survival to hospital discharge in patients receiving ECMO was 68%. Survival of patients receiving ECMO within 7 days from the onset of mechanical ventilation was 77%. The length of mechanical ventilation prior to ECMO was an independent predictor of mortality.

Conclusions

A network organization based on preemptive patient centralization allowed a high survival rate and provided effective and safe referral of patients with severe H1N1-suspected ARDS.

Keywords

Viral infection Extracorporeal membrane oxygenation Preparedness plan ARDS 

Supplementary material

134_2011_2301_MOESM1_ESM.doc (175 kb)
Supplementary material 1 (DOC 175 kb)

Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Nicolò Patroniti
    • 1
    • 2
  • Alberto Zangrillo
    • 3
  • Federico Pappalardo
    • 3
  • Adriano Peris
    • 4
  • Giovanni Cianchi
    • 4
  • Antonio Braschi
    • 5
  • Giorgio A. Iotti
    • 6
  • Antonio Arcadipane
    • 7
  • Giovanna Panarello
    • 7
  • V. Marco Ranieri
    • 8
  • Pierpaolo Terragni
    • 8
  • Massimo Antonelli
    • 9
  • Luciano Gattinoni
    • 10
  • Fabrizio Oleari
    • 11
  • Antonio Pesenti
    • 1
  1. 1.Department of Experimental MedicineUniversity of Milan-BicoccaMonzaItaly
  2. 2.Department of Perioperative Medicine and Intensive CareSan Gerardo HospitalMonzaItaly
  3. 3.Dipartimento di Anestesia Cardiaca e Terapia IntensivaUniversità Vita-Salute San RaffaeleMilanItaly
  4. 4.Anestesia e Rianimazione di Emergenza, Dipartimento DAI e Medicina e Chirurgia Generale e d’UrgenzaAzienda Ospedaliero Universitaria CareggiFlorenceItaly
  5. 5.Dipartimento di Scienze Chirurgiche Rianimatorie-Riabilitative e dei Trapianti d’Organo, Sezione di Anestesia Rianimazione e Terapia Antalgica, Anestesia e Rianimazione I Dipartimento di Emergenza UrgenzaUniversità degli Studi di Pavia, IRCCS Policlinico San MatteoPaviaItaly
  6. 6.Anestesia e Rianimazione IIFondazione IRCCS Policlinico San MatteoPaviaItaly
  7. 7.Terapia IntensivaIstituto Mediterraneo per i Trapianti e Terapie ad alta SpecializzazionePalermoItaly
  8. 8.Dipartimento di Anestesiologia e Medicina degli Stati CriticiUniversità di TorinoTurinItaly
  9. 9.Dipartimento di Terapia Intensiva e AnestesiologiaUniversità Cattolica del Sacro CuoreRomeItaly
  10. 10.Dipartimento di Anestesiologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Maggiore PoliclinicoUniversità degli Studi di MilanoMilanItaly
  11. 11.Dipartimento della Prevenzione e ComunicazioneMinistero della SaluteRomeItaly

Personalised recommendations