The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

HFOV FOR ARDS AND H1N1 INFLUENZA: A RETROSPECTIVE REVIEW

Crystal Robertson, Kimberly Bauser, Carl Haas; University of Michigan Hospital, Monroe, MI

BACKGROUND: We use HFOV for refractory hypoxemia and applied it to patients with H1N1 Influenza ARDS. STUDY OBJECTIVE: To compare treatment and outcome of the H1N1 patients with non-H1N1 HFOV patients. STUDY DESIGN: Retrospective review of the following from a HFOV database: gender, ARDS trigger, BMI, mortality, use of iNO and ECMO, incidence of airleaks, and duration of ventilation. OI, and PaCO2 were recorded at baseline, and at hour 1, 12, 24, 48 of HFOV. RESULTS: 28 H1N1 (H) patients were compared with 28 non-H1N1 (NH) patients during a similar period. There were 68% vs 64% males, with a mean age of 40 + 12 vs 43 + 20 years and a BMI of 40 + 10 vs 32 + 10 for H and NH respectively. ARDS triggers for NH included pneumonia (43%) and sepsis (39%), while all H was pneumonia. Air leaks were present at baseline in 7% (H) and 25% (NH) of patients and a new leak developed in 18% (H) and 7% (NH). iNO was used with 60% (H) vs. 50% (NH) of patients. ECMO was used pre-HFOV in 7% (H) vs 4% (NH) of the patients and during HFOV 25% (H) vs 18% (NH). Days of ventilation pre-HFOV was 3.3 + 4 (H) vs 3.6 + 3 d (NH). Mean duration of HFOV was 3.9 + 3 (H) vs 2.6 + 2 d (NH); median was 4 vs 2 d. Hospital mortality was 50% for H and 39% for NH. Pre-HFOV and hr 1, 12, 24, and 48 values (mean +SD) for OI, PaCO2 and HFOV frequency (Hz) were: (please see attached table) CONCLUSION: H1N1 patients tended to be younger and heavier, and their degree of hypoxia more refractory to treatment (slower to respond, increased use of iNO and ECMO, longer HFOV DOV), and their mortality higher than non-H1N1 HFOV patients. Sponsored Research - None