Comparison of ECMO run between H1N1 acute respiratory failure vs. non H1N1 acute respiratory failure

Abstract

First case of adult ECMO was reported in 1971 however after that ECMO was hardly been used in adult till 2009. The real boost to ECMO in adult respiratory failure came after 2009 mainly contributed to successful Cesar trial & an outbreak of H1N1. There are ample of papers published on H1N1 & ECMO but hardly a few papers on ECMO in non H1N1 respiratory failure. However the incidence of acute respiratory failure secondary to other tropical infections like Malaria, dengue, leptospirosis, bacterial & viral pneumonia are much higher in India & Asian countries. ECMO is underutilized for these tropical infections especially in India mainly due to financial constraints but also because of lack of awareness & lack of published data to support. We thought of publishing our own data on role of ECMO and outcome in H1N1 & non H1N1 respiratory failure. Methods: It is a Retrospective analysis of data collected of patients with acute respiratory failure managed on ECMO from January 2010 to November 2018. Results: The total 169 patients of respiratory failure were treated with ECMO during specified period. Out of this 169, 81 patients had H1N1 infection & remaining 88 were some other cause of respiratory failure all categorized under Non H1N1 group.There was not much difference in the survival in both the groups but ECMO runs remain significantly short (9.5 vs. 18.78 days) in non H1N1 group. Long run ECMO more than 30 days is seen in H1N1 with good survival (71.42%). Conclusions: ECMO is equally effective in Non H1N1 & H1N1 respiratory failure with much shorter ECMO run in Non H1N1 respiratory failure. Survival with ECMO in tropical infections like Malaria, Dengue & Leptospirosis is more than 60%. Keywords: ECMO in H1N1, Tropical disease & ECMO, Malaria, Leptospirosis, ARDS, Dengue