Didn't we learn anything back in the 70's? Newborn Respiratory Distress is really the only thing that ECMO is effective for.
Posted on 10/13/2009 7:01:42 AM PDT by neverdem
HEALTH - Blood oxygenation appears to be the key to surviving swine flu for patients suffering respiratory failure, new research shows.
The observational study, carried out by New Zealand and Australian flu investigators between June 1 and August 31 this year, showed most patients who experienced respiratory failure after contracting swine flu survived if they were treated with extracorporeal membrane oxygenation (ECMO), a type of life support that adds oxygen to the blood.
The study focused on 68 patients with severe swine flu associated acute respiratory distress, who received ECMO in 15 intensive care units across New Zealand and Australia.
"We looked at a number of factors associated with patients receiving ECMO, such as the incidence, degree of lung dysfunction, clinical features, technical characteristics, duration, complications, and survival," Auckland City Hospital's cardiothoracic intensive care specialist Shay McGuinness said.
"By doing this we have established the importance of ECMO as a treatment option for patients with severe influenza A H1N1 (swine flu) associated acute respiratory distress.
"Despite the severity of their illness and the lengthy period of time on ECMO life-support most of these patients survived."
Dr McGuinness said 54 of the 68 patients had survived and 14 had died. Six were still being treated in intensive care units.
"These findings are important to our colleagues all over the world and should be used to facilitate health care planning and clinical management for these complex patients during the ongoing pandemic," Dr McGuinness said.
The study was due to be published in the Journal of the American Medical Association on November 4, but will be published early online because of the importance of its findings for public health.
Ha,Ha!
Got a brigde to nowhere and a swamp to sell ya.
That's serious stuff.
I've had pneumonia, but it never came to this.
You seem to enjoy making light of a treatment that is saving people who would otherwise die from swine flu.
Well this is just about - let's see - 78 years LATE.
Dr. Otto Warburg received the Nobel Prize in 1931 for the discovery that, unlike all other cells in the human body, cancer cells do not breathe oxygen. Cancer cells are anaerobic, which means that they derive their energy without oxygen. Further, it turns out that cancer cells cannot survive even in the presence of high levels of oxygen. This knowledge has given rise to a variety of relatively successful treatments based on oxygenating the tissues, such as the use of intravenous hydrogen peroxide, hyperbaric oxygen tanks, and blood ozonation (for more info, see Oxygen Kills Cancer).
One has to be a little bit careful here. ECMO is a very invasive, very expensive technology that basically duplicates what the heart-lung machine does during open heart surgery.
It routes the blood outside the body (”extra coporeal”) and then oxygenates it with a membrane oxygenator. Hence Extra Corporeal Membrane Oxgygenation.
So the question is - does the ECMO “fix” the swine flu issue? Or does it simply keep the patient alive until the patient can fix himself?
My guess is it’s the latter.
Just to be clear, these folks are NOT dying from the ‘swine flu’, they are dying from respiratory failure. Essentially their lungs fill with fluid to the point the cannot exchange gases in their lungs. They ‘drown.’
The respiratory failure is caused by fluid accumulating in the lungs (pneumonia) and other factors reducing the transfer of oxygen to the blood in the alveoli (the grape-like structures in the lungs). Pneumonia is a complication (generally bacterial infection) of the flu. The body’s immune system is compromised, histamine is running rampant, and an environment for bacterial growth in the lungs is ready-made to cause a person to lose the ability to absorb oxygen through their lungs. (the bacteria were already in the lungs, but the person could previously keep it in check. The flu weakens their ability to fight the infection.)
Extra corporeal (outside the body) oxygenation is a demonstrated way of getting O2 into the blood/ CO2 out .. ie a proxy for the lungs when lung function is grossly degraded.
this is not new to medicine.
simply an FYI, not contention.
Interesting. Oxygen kills cancer cells?
Honestly I have never heard of this. My respiratory chemistry knowledge is about 35 years old, but ...
AFAIK, all human cells, even cancer cells need a hydrogen acceptor (oxygen) as they respire. Most earthly organisms that are facultative anaerobes substitute Sulfur for Oxygen as a hydrogen acceptor ... and that’s why the mud stinks at low tide for example — the organisms ‘exhale’ H2S instead of H2O.
But I am ready to enlightened.
I think you’re correct. I was surprised that the people that were most at risk of dying from the Spanish flu in the early 1900’s were the ones with the strongest immune systems. Before reading about the pandemic I thought the youngest and oldest were the ones that were affected the most.
By substituting equipment for the lungs and enabling the removal of fluids from lungs, ECMO makes sense, Otherwise the infected can die by drowning. The body’s immune system is one of the problems to be managed. If it over reacts, you can die.
I don’t know how many ECMO machines are available for use in the USA, but I suspect that it would not be helpful in the middle of a full blown outbreak.
Right - most folks think that the 1918 deaths were due to an overblown immune response as opposed to the destructive effects of the virus itself. Perhaps a bit of a subtle point - but perhaps not if you can target therapy at the immune reponse.
WOW! YOU DON'T SAY?! What's next... "Blood infusions appear to be the key to losing blood..."?
When my daughter was 6 weeks old, she almost died of RSV. She was on a ventilator, and it wasn’t working. They were talking about ECMO, but they didn’t have one for a baby at the hospital she was at and they didn’t think she could handle being transferred to another hospital.
(At that time, I stopped listening, and broke down crying.)
Thank God, my daughter started doing better. They gave her a blood transfusion, and she finally started coming out of it. She’s almost 13 now, and I am a little worried about H1N1.
Anyway, I know lots of hospitals don’t have ECMO.
When my daughter was 6 weeks old, she almost died of RSV. She was on a ventilator, and it wasn’t working. They were talking about ECMO, but they didn’t have one for a baby at the hospital she was at and they didn’t think she could handle being transferred to another hospital.
(At that time, I stopped listening, and broke down crying.)
Thank God, my daughter started doing better. They gave her a blood transfusion, and she finally started coming out of it. She’s almost 13 now, and I am a little worried about H1N1.
Anyway, I know lots of hospitals don’t have ECMO.
Didn't we learn anything back in the 70's? Newborn Respiratory Distress is really the only thing that ECMO is effective for.
My goodness! What a horrible experience!
I am so glad that your daughter made it through.
My little 6 week old son had a viral pneumonia. Thankfully, a 10 day stay in the hospital inside an oxygen tent was all that he needed. I doubt though without suctioning, oxygen, added moisture to the air, and respiratory therapy, he would have made it.
What a blessing that she (and you) made it through that horrible time.
Dr. Otto Warburg, Director, Max Planck-Institute for Cell Physiology, Berlin-Dahlem, 1931 Nobel Prize in Medicine:
The oxygen-transferring ferment of respiration of Cells.
"For his discovery of the nature and mode of action of the respiratory enzyme, the Nobel Prize has been awarded to him in 1931. This discovery has opened up new ways in the fields of cellular metabolism and cellular respiration. He has shown, among other things, that cancerous cells are acidic, and that they can live and develop, even in the absence of oxygen."
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