Uso de oxigenador de membrana extracorpóreo en pacientes con insuficiencia respiratoria aguda grave refractaria en la epidemia de gripe estacional 2010-2011 por influenza A (H1N1) en Espa？a

objective: to describe the use of extracorporeal membrane oxygenation (ecmo) in refractory respiratory failure. design: a prospective, observational, multi-center study was carried out. setting: intensive care units (icu) in 148 spanish hospitals. patients: subjects admitted during epidemic weeks 50-52 of 2010 and weeks 1-4 of 2011, receiving respiratory support with ecmo. main variables of interest: clinical and blood gas features, complications and survival of patients with ecmo. results: out of 300 icu admitted patients, 239 (79.6%) were mechanically ventilated. ecmo was available in only 5 icus. nine patients were treated with ecmo (3% of the total and 3.2% of the ventilated patients). in 77.7% of the cases some hypoxemia rescue technique was previously used. ecmo was initiated when ards proved refractory to standard treatment. ecmo therapy was started a median of 4.5 days after the onset of mechanical ventilation. the median duration of ecmo was 6 days. veno-venous (vv) ecmo was the most frequent cannulation mode (88.9%). four patients had complications associated with ecmo therapy. the median icu and hospital stay was 17 and 29 days, respectively. in five patients (55.5%), ecmo assistance was satisfactory suspended. the icu and hospital survival rate was 44.4%. conclusions: the use of ecmo in refractory respiratory failure in patients with influenza a (h1n1) is rare in spain. the hospital survival achieved with its use allows it to be regarded as a possible rescue technique in these patients.