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Dtsch Arztebl Int. 2013 Aug; 110(33-34): 543–549.
Steffen Weber-Carstens, PD Dr. med.,*,1Anton Goldmann, Dr. med.,1Michael Quintel, Prof. Dr.,2Armin Kalenka, PD Dr. med.,3Stefan Kluge, PD Dr. med.,4Jürgen Peters, Prof. Dr. med.,5Christian Putensen, Prof. Dr. med.,6Thomas Müller, PD Dr. med.,7Simone Rosseau, Dr. med.,8Bernhard Zwißler, Prof. Dr. med.,9 and Onnen Moerer, PD Dr. med.2

Abstract

Background

During the H1N1 pandemic of 2009 and 2010, the large number of patients with severe respiratory failure due to H1N1 infection strained the capacities of treatment facilities for extracorporeal membrane oxygenation (ECMO) around the world. No data on this topic have yet been published for Germany.

Methods

During the pandemic, the German ARDS Network (a task force of the DIVI’s respiratory failure section) kept track of the availability of ECMO treatment facilities with a day-to-day, Internet-based capacity assessment. In cooperation with the Robert Koch Institute, epidemiological and clinical data were obtained on all patients treated for influenza in intensive care units.

Results

116 patients were identified who had H1N1 disease and were treated in the intensive care units of 9 university hospitals and 3 other maximum medical care hospitals. 61 of them received ECMO. The overall mortality was 38% (44 of 116 patients); among patients receiving ECMO, the mortality was 54% (33 of 61 patients). The mortality was higher among patients who had an accompanying malignancy or immune deficiency (72.2%).

Conclusion

Even persons without any other accompanying disease developed life-threatening respiratory failure as a result of H1N1 infection, and many of these patients needed ECMO. This study reveals for the first time that the mortality of H1N1 infection in Germany is comparable to that in other countries. H1N1 patients with acute respiratory failure had a worse outcome if they also had serious accompanying diseases.

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