• Da-wei Duan, Tong Li, Ying-zhi Qin, Lei Xu, Cheng-xiu Zhao, Xiao-min Hu, Peng Wu, Qiang Zhang, and Yu-heng Lang.
• Tianjin Third Central Hospital of Tianjin Medical University, Tianjin 300170, China.
• Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010 Mar 1;22(3):161-3.

ObjectiveTo summarize the clinical method and initial experience of extracorporeal membrane oxygenation (ECMO) supportive treatment in influenza A H1N1 serious patients.MethodsIn 5 critically ill patients with influenza A H1N1, their arterial oxygen saturation was 0.70 to 0.85 with oxygen concentration (FiO(2)) 1.00 under mechanical ventilation. In these 5 patients, 3 males and 2 females, vein-vein mode ECMO bypass (femoral vein-internal jugular vein) was carried out to assist pulmonary function. The ratio between ECMO oxygen flow and blood flow was 2-1:1, FiO(2) was 0.21 to 1.00, FiO(2) for mechanical ventilation was 0.30 to 0.70, and positive end expiratory pressure (PEEP) was 5-10 cm H(2)O (1 cm H(2)O= 0.098 kPa). Activated coagulation time (ACT) was maintained at 160-250 s. When artery oxygen saturation and artery-venous blood gas became normal on discontinuation of ECMO, ECMO was weaned, and venous cannulas were removed. Mechanical ventilation was continued.ResultsIn 5 patients the assisting time of ECMO was 48-330 hours, the mean duration was 178.2 hours. ECMO assisted flow was 2.4-4.0 L/min. The observation time after stoppage of ECMO was 4-24 hours. Four patients were weaned from ECMO, with continuation of assisted respiration successfully. One patient died because the family member gave up hope and the treatment was stopped.ConclusionVein-vein mode ECMO bypass through femoral vein-internal jugular vein can offer effective aid to pulmonary function in influenza A H1N1 patients who are critically ill. The strategy can win time for the patients to be able to continue mechanical ventilation treatment.

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