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Letters |

ECMO Centers and Mortality From Influenza A(H1N1)

Joost D. Haeck, MD, PhD; Dave A. Dongelmans, MD, PhD; Marcus J. Schultz, MD, PhD
JAMA. 2012;307(5):454-455. doi:10.1001/jama.2012.57.
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To the Editor: Dr Noah and colleagues found that the mortality rate was lower among patients with severe suspected or confirmed 2009 influenza A(H1N1) and acute respiratory distress syndrome (ARDS) who were transferred to 4 specialized centers in the United Kingdom for treatment with extracorporeal membrane oxygenation (ECMO) compared with matched critically ill patients who were not transferred.1

The ventilatory parameters in the ECMO-referred patients at transfer are shown in eTable 2 of the article. The median tidal volume was 5.2 mL/kg (interquartile range, 4.0-6.5 mL/kg) of actual body weight. However, information on the respiratory values during treatment in non–ECMO-referred patients with H1N1 and ARDS was not described. Because lower tidal volumes are associated with a lower mortality rate in ARDS patients due to reduced ventilator-associated lung injury,2 it would be valuable to also provide information on the respiratory values during treatment in non–ECMO-referred patients with H1N1 and ARDS.

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February 1, 2012
Giles J. Peek, FRCS (CTh), MD; Kathryn M. Rowan, PhD
JAMA. 2012;307(5):454-455. doi:10.1001/jama.2012.58.
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