These findings were published in the Lancet in an article by Prof Miranda Mugford of the University of East Anglia and colleagues Dr Giles Peek of Glenfield Hospital in Leicester, and Prof Diana Elbourne of the London School of Hygiene and Tropical Medicine.

ECMO is cost-effective and has already been a vital tool for battling swine flu. It will be essential during the northern hemisphere winter when cases could rise again dramatically.

Severe acute respiratory failure (ARF) causes high mortality in adults despite improvements in ventilation techniques and other treatments such as steroids and inhaled nitric oxide.

Conventional management is by intermittent positive-pressure ventilation where oxygen-enriched air is blown into the lungs at high pressure. This in turn causes oxygen toxicity and pressure injury to the lung tissue on top of the underlying lung disease, delaying or preventing recovery.

ECMO is an alternative which uses heart-lung bypass technology to provide gas exchange outside the body, allowing time for the lung treatment and recovery. Heparin is also given to prevent the blood clotting when it passes through the ECMO system.

In the Lancet study, the authors compared treatment by a specialised ECMO team with care from specialist intensive-care unit teams using conventional ventilation.

Their results showed that use of ECMO could lead to one extra survivor without disability for every six patients treated.

Dr Peek says: ‘Swine flu causes a viral pneumonia which can result in severe respiratory failure in young adults. We have already used ECMO during the first wave of the pandemic with good effect and we are expecting ECMO to prove an invaluable weapon in the fight against the winter resurgence of the infection, as has already been seen during the Australasian winter.’

Source: University of East Anglia