Patients with swine flu who experience severe respiratory failure should be given a specialist lung treatment, researchers say today.
The treatment — for which one Scottish woman, Sharon Pentleton was flown to Norway — saves one extra life for every six patients compared with conventional treatment for those who are critically ill, the study in The Lancet medical journal reports.
There is only one adult unit in the UK which offers the treatment, called extracorporeal membrane oxygenation (ECMO). It involves circulating the patient’s blood outside the body and adding oxygen to it artificially.
The Glenfield Hospital in Leicester has five ECMO beds and treats around 100 patients a year on average. The unit can be expanded to ten beds if necessary, but Ms Pentleton, who is pregnant, had to be flown to University Hospital in Stockholm for the treatment in July because the Leicester unit was full. She was successfully treated and has now returned to her Scottish home.
Giles Peek, who led the study at the ECMO unit at Glenfield Hospital, said there was likely to be a “big increase” in the need for ECMO as swine flu enters its second wave this autumn.
University Hospitals Leicester NHS Trust said it expected ECMO to be an “essential weapon” in the expected resurgence of illness due to the H1N1 virus this winter.
The study looked at 180 patients aged 18 to 65 with severe lung failure who were treated in Leicester. It found that 63 per cent of patients given ECMO survived to six months without disability compared with 47 per cent of those who were assigned to conventional treatment with a ventilator.
Patients with reversible respiratory failure should be treated with ECMO to “significantly improve survival without severe disability”, the researchers concluded.
But last week, Sir Liam Donaldson, the Government’s Chief Medical Officer, questioned the value of ECMO for adult patients, saying that medical opinion on the treatment was “divided”. He said that 13 nurses were required to run one ECMO bed, compared with six or seven for a normal intensive care bed, meaning the cost of providing the procedure was doubled.
Dr Peek said that Sir Liam was reflecting the scepticism felt about ECMO in some parts of the intensive care community. But he said this was because some units had “dabbled” with ECMO without proper training and had had little success.
In Leicester, of 13 swine flu patients treated so far with ECMO, 85 per cent have survived. But of an estimated 100 patients treated with the procedure for other respiratory illness in other hospitals in Britain, none had survived, Dr Peek said.
He called for the Government to fund the use of ECMO properly so there could be an expansion of the number of beds this winter if needed, but said that this should involve experts from Leicester advising other trusts rather than “people going it alone.”
Asked if he was concerned there would not be enough ECMO beds for swine flu patients this winter, he said: “Yes and no. It depends on the Government’s approach. If the chief medical officer is rubbishing [the research], I don’t think we are going to have an informed approach.”
ECMO units for children are based in specialist neonatal units in Great Ormond Street Hospital, Freeman Hospital in Newcastle upon Tyne, and Yorkhill Hospital in Glasgow.
The deaths of at least 75 people in Britain have been directly linked to swine flu.
The treatment — for which one Scottish woman, Sharon Pentleton was flown to Norway — saves one extra life for every six patients compared with conventional treatment for those who are critically ill, the study in The Lancet medical journal reports.
There is only one adult unit in the UK which offers the treatment, called extracorporeal membrane oxygenation (ECMO). It involves circulating the patient’s blood outside the body and adding oxygen to it artificially.
The Glenfield Hospital in Leicester has five ECMO beds and treats around 100 patients a year on average. The unit can be expanded to ten beds if necessary, but Ms Pentleton, who is pregnant, had to be flown to University Hospital in Stockholm for the treatment in July because the Leicester unit was full. She was successfully treated and has now returned to her Scottish home.
Giles Peek, who led the study at the ECMO unit at Glenfield Hospital, said there was likely to be a “big increase” in the need for ECMO as swine flu enters its second wave this autumn.
University Hospitals Leicester NHS Trust said it expected ECMO to be an “essential weapon” in the expected resurgence of illness due to the H1N1 virus this winter.
The study looked at 180 patients aged 18 to 65 with severe lung failure who were treated in Leicester. It found that 63 per cent of patients given ECMO survived to six months without disability compared with 47 per cent of those who were assigned to conventional treatment with a ventilator.
Patients with reversible respiratory failure should be treated with ECMO to “significantly improve survival without severe disability”, the researchers concluded.
But last week, Sir Liam Donaldson, the Government’s Chief Medical Officer, questioned the value of ECMO for adult patients, saying that medical opinion on the treatment was “divided”. He said that 13 nurses were required to run one ECMO bed, compared with six or seven for a normal intensive care bed, meaning the cost of providing the procedure was doubled.
Dr Peek said that Sir Liam was reflecting the scepticism felt about ECMO in some parts of the intensive care community. But he said this was because some units had “dabbled” with ECMO without proper training and had had little success.
In Leicester, of 13 swine flu patients treated so far with ECMO, 85 per cent have survived. But of an estimated 100 patients treated with the procedure for other respiratory illness in other hospitals in Britain, none had survived, Dr Peek said.
He called for the Government to fund the use of ECMO properly so there could be an expansion of the number of beds this winter if needed, but said that this should involve experts from Leicester advising other trusts rather than “people going it alone.”
Asked if he was concerned there would not be enough ECMO beds for swine flu patients this winter, he said: “Yes and no. It depends on the Government’s approach. If the chief medical officer is rubbishing [the research], I don’t think we are going to have an informed approach.”
ECMO units for children are based in specialist neonatal units in Great Ormond Street Hospital, Freeman Hospital in Newcastle upon Tyne, and Yorkhill Hospital in Glasgow.
The deaths of at least 75 people in Britain have been directly linked to swine flu.
No comments:
Post a Comment