Lung Failure in Swine-Flu Patients May Spur Life-Support Demand

Oct. 13 (Bloomberg) -- Machines that pump blood through an artificial lung helped save dozens of critically ill swine flu patients, doctors in Australia and New Zealand found.

The finding, based on the first population-wide study of the use of lung-bypass machines in the influenza pandemic, suggests Northern Hemisphere nations can expect a winter surge in demand for life-support equipment made by companies including Getinge AB and Medtronic Inc.

The lung-bypass technique was used in 68 flu patients in both countries who developed such severe lung damage that they weren’t able to breathe, according to a study published in the Journal of the American Medical Association yesterday. Almost half of those given the procedure were able to walk out of the hospital after suffering acute respiratory distress syndrome, a condition fatal in up to 48 percent of cases.

“We have a gut feeling that these patients would have died more frequently and that we did improve the likelihood of their survival,” said Andrew Davies, deputy director of intensive care at Melbourne’s Alfred Hospital and the study’s lead author.

From June 1 to Aug. 31, the procedure was used in New Zealand and Australia on patients with confirmed or suspected swine flu at a rate of 2.6 per million people.

An additional 133 flu patients received mechanical ventilation, but not the lung-bypass procedure known as extracorporeal membrane oxygenation or ECMO. The study didn’t include a case-controlled comparison of patient outcomes in both groups.

‘Dreadfully Sick’

“They were dreadfully sick as a bunch when we put them on ECMO, and you would have thought that group of patients would have had a higher mortality,” Davies said.

The average age of patients with the new H1N1 strain who received ECMO at 15 intensive care sites in Australia and New Zealand was 34.4 years, the doctors said.

As of Sept. 7, 48 of the 68 ECMO patients had been discharged from the intensive care unit, of whom 32 had been discharged from the hospital and 16 were still hospitalized. Fourteen patients had died and six remained in the ICU, two of whom were still receiving ECMO, according to the study.

In comparison, only four patients received ECMO for acute respiratory distress syndrome across the 15 ICUs the previous winter in Australia and New Zealand. The incidence of ECMO in the three months ended Aug. 31, 2008, was 0.15 cases per million people.

As swine flu spreads in the Northern Hemisphere winter, the U.S. might expect to provide ECMO to about 800 H1N1 patients and the European Union to 1,300 patients, the authors said.



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