Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic

Pediatr Crit Care Med. 2011 Jul;12(4):426-30. doi: 10.1097/PCC.0b013e3181ff41c1.


Objective: We report the process used to rapidly develop a collaborative adult respiratory extracorporeal membrane oxygenation program as a response to caring for young adult patients with refractory hypoxemia in the setting of the pH1N1 pandemic.

Design: Interdisciplinary response of a complex medical system to a public health crisis. PATIENTS, INTERVENTIONS, MEASUREMENTS, AND MAIN RESULTS: After the successful use of extracorporeal membrane oxygenation in young adults with pH1N1-induced acute respiratory distress syndrome refractory to conventional therapies, an adult venovenous extracorporeal membrane oxygenation program was implemented over an 8-wk period. Implementation of this program involved a number of key steps that were crucial in the development process, including administrative and institutional support, multidisciplinary leadership and collaboration, extensive interdisciplinary educational initiatives, and substantial technical modifications.

Conclusions: In the setting of the pH1N1 influenza pandemic, an adult respiratory extracorporeal membrane oxygenation program was successfully developed to complement an established neonatal-pediatric program. This program expansion integrated all of the necessary components involved in the development process from start to finish and confirms that a healthcare system can respond very quickly and successfully to an urgent healthcare need.

MeSH terms

  • Adult
  • Cooperative Behavior
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Humans
  • Hypoxia / etiology
  • Hypoxia / therapy*
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / complications*
  • Influenza, Human / epidemiology
  • Pandemics
  • Program Development / methods*
  • Respiratory Distress Syndrome / therapy*
  • Respiratory Distress Syndrome / virology
  • Young Adult