Global Trends in Extracorporeal Membranous Oxygenation Use and Survival of Patients With Influenza-Associated Illness
Open accessAbstract
Objectives: To determine the overall use of extracorporeal membranous oxygenation for influenza-associated illness and describe risk factors associated with mortality in these patients. Design: Retrospective multicenter cohort analysis. Setting: The international Extracorporeal Life Support Organization database was queried for patients with influenza-associated illness on extracorporeal membranous oxygenation from 1992 to 2014. Patients: In total, 1,654 patients with influenza-associated illness on extracorporeal membranous oxygenation. Interventions: None. Measurements and Main Results: Demographic and clinical data collected included age, type of support, duration of support, type of microbial codetection, complications, and survival status at discharge. The primary outcome of interest was survival to hospital discharge. From 1992 to 2014, 1,688 (3%) of the 61,336 extracorporeal membranous oxygenation runs were due to influenza-associated illness reflecting 1,654 unique patients: 30 (2%) were neonates, 521 (31%) were pediatric patients, and 1,103 (67%) were adults. Extracorporeal membranous oxygenation use for influenza-associated illness increased from 1992 to 2014, with a marked increase in use after the 2009 H1N1 pandemic. Survival to hospital discharge of patients with influenza-associated illness on extracorporeal membranous oxygenation was 63% and was not affected by bacterial codetection. However, when patients with Staphylococcus aureus codetection were compared with those with another bacterial codetection, their survival to hospital discharge was significantly lower (52% vs 67%; p < 0.01). In a logistic regression model, the effect of S. aureus on in-hospital mortality varied by age group, with younger patients with S. aureus having increased in-hospital mortality. Conclusions: Extracorporeal membranous oxygenation use for individuals with influenza increased over time, particularly after the 2009 H1N1 pandemic, most notably among older adults. Survival to hospital discharge for patients with influenza on extracorporeal membranous oxygenation was slightly higher than survival to hospital discharge for respiratory illness due to any cause. Bacterial codetection was common among patients with influenza on extracorporeal membranous oxygenation and was associated with increased days on extracorporeal membranous oxygenation but not increased mortality. Only S. aureus codetection in children was associated with increased in-hospital mortality.
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The use of ECMO rose sharply in 2009.
“The use of ECMO rose sharply in 2009 and is associated with high rates of survival [47].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [47]
ECMO use is associated with high rates of survival.
“The use of ECMO rose sharply in 2009 and is associated with high rates of survival [47].”
From The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09. (2018) · cites this paper as [47]
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- [22]Epperson S Blanton L Kniss K Mustaquim D Steffens C Wallis T Influenza activity - United States, 2013–14 season and composition of the 2014–15 influenza vaccines MMWR 2014 63 22 483 490 24898165 PMC5779357
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- Authors
- de St. Maurice, A. M., Bridges, B. C., Rycus, P. T., Fonnesbeck, C. J., Fleming, G. M., & Halasa, N. B.
- Affiliations
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
- Vanderbilt University (US)
- University of Michigan (US)
- ORCID
- Venue
- Pediatric Critical Care Medicine
- Published
- 2016-09
- Volume
- 17
- Issue
- 9
- Pages
- 876-883
- ISSN
- 1529-7535 (ISSN-L)
- PMC
- PMC5008980
- OpenAlex
- W2469804398
- Cited by
- 14
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 3 · 2022: 1 · 2021: 4 · 2019: 1 · 2018: 1 · 2017: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pediatric Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (T32AI095202)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Keywords
- extracorporeal membrane oxygenation, survival to hospital discharge, in-hospital mortality, bacterial co-infection, 2009 H1N1 pandemic, mortality risk factors, older adults, pediatric patients, neonates, respiratory failure, sepsis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Influenza, Human, Male, Middle Aged, Practice Patterns, Physicians', Retrospective Studies, Risk Factors, Global Health, Extracorporeal Membrane Oxygenation, Logistic Models, Databases, Factual, Treatment Outcome, Hospital Mortality, Young Adult
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