{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:37:22Z","timestamp":1777934242786,"version":"3.51.4"},"reference-count":72,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2011,4,1]],"date-time":"2011-04-01T00:00:00Z","timestamp":1301616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2011,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation (ECMO) incorporates surgical techniques as adjuncts in the management of refractory respiratory dysfunction. For many years, its primary application was for support of neonatal infants in cardiorespiratory failure. As the 2009 H1N1 influenza A pandemic developed, more reports came in of severe respiratory dysfunction and even death that seemed to be occurring preferentially in younger adults. Centers with the capability began to use ECMO to salvage these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The H1N1 virus is a subtype of influenza A. The hemagglutinin receptor binding is similar to that of the seasonal influenza virus, but 2009 H1N1 also binds to \u03b12,3-linked receptors, which are found in the conjunctivae, distal airways, and alveolar pneumocytes. Influenza viruses elude host immune responses through drift and shift in the hemagglutinin (HA) and neuraminidase (NA) proteins. The incubation period ranges from 1\u20137 days. The majority of patients present with fever and cough, but a broad spectrum of clinical syndromes has been reported, and laboratory testing remains the mainstay of diagnosis. Most patients recover within a week without treatment. The H1N1 virus remains largely sensitive to the NA inhibitors but is resistant to the matrix protein-2 inhibitors. Extracorporeal membrane oxygenation provides continuous pulmonary (and sometimes cardiac) support and minimizes ventilator-induced lung injury. The potential for life-threatening complications is high. In 2009, in the Conventional Ventilation or ECMO for Severe Adult Respiratory Failure (CESAR) randomized trial of ECMO, the overall survival rate was 63% in the ECMO group compared with 47% in the control group (p\u2009=\u20090.03). Similar studies have been reported from Australia and New Zealand, Canada, and France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Supportive management is continued along with ECMO. Antiviral drugs and antimicrobial agents should be given as appropriate, as should nutritional support. Volume management should be used. Ventilator settings should be reduced as ECMO support allows, with a goal of reducing airway pressures, ventilator rate, and F\n                      <jats:sc>i<\/jats:sc>\n                      O\n                      <jats:sub>2<\/jats:sub>\n                      . Complications of ECMO are common. Bleeding, the most common, can result in death, especially if it occurs intracranially.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2010.082","type":"journal-article","created":{"date-parts":[[2011,5,5]],"date-time":"2011-05-05T12:57:06Z","timestamp":1304600226000},"page":"151-158","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Extracorporeal Membrane Oxygenation in the Context of the 2009 H1N1 Influenza A Pandemic"],"prefix":"10.1177","volume":"12","author":[{"given":"Kristen C.","family":"Sihler","sequence":"first","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline K.","family":"Park","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,5,5]]},"reference":[{"key":"e_1_3_1_2_2","first-page":"369","article-title":"Update: influenza activity\u2014United States, September 28, 2008\u2013April 4, 2009, and composition of the 2009\u201310 influenza vaccine","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Update: influenza activity\u2014United States, September 28, 2008\u2013April 4, 2009, and composition of the 2009\u201310 influenza vaccine. MMWR Morb Mortal Wkly Rep, 2009; 58:369\u2013374.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_3_2","first-page":"400","article-title":"Swine Influenza A (H1N1) infection in two children\u2014Southern California, March\u2013April 2009","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Swine Influenza A (H1N1) infection in two children\u2014Southern California, March\u2013April 2009. MMWR Morb Mortal Wkly Rep, 2009; 58:400\u2013402.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_4_2","first-page":"431","article-title":"Update: Infections with a swine-origin influenza A (H1N1) virus\u2014United States and other countries, April 28, 2009","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Update: Infections with a swine-origin influenza A (H1N1) virus\u2014United States and other countries, April 28, 2009. MMWR Morb Mortal Wkly Rep, 2009; 58:431\u2013433.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_5_2","first-page":"453","article-title":"Update: novel influenza A (H1N1) virus infections\u2014Worldwide, May 6, 2009","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Update: novel influenza A (H1N1) virus infections\u2014Worldwide, May 6, 2009. MMWR Morb Mortal Wkly Rep, 2009; 58:453\u2013458.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature08182"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nbt0909-797"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/440435a"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2010.091087"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1177238"},{"key":"e_1_3_1_11_2","volume-title":"Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases","author":"Mandell GL","year":"2005","unstructured":"Mandell GL, , Bennett JE, , Dolin R. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Sixth. Philadelphia: Elsevier Churchill Livingstone, 2005."},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1201.051254"},{"key":"e_1_3_1_13_2","first-page":"521","article-title":"Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Serum cross-reactive antibody response to a novel influenza A (H1N1) virus after vaccination with seasonal influenza vaccine. MMWR Morb Mortal Wkly Rep, 2009; 58:521\u2013524.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906453"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1000449"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905498"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906089"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1177373"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906612"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1086\/648508"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.10.005"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0903810"},{"key":"e_1_3_1_23_2","first-page":"185","article-title":"Clinical observations from Mexico and other affected countries, May 2009","volume":"84","author":"Human infection with new influenza A (H1N1) virus:","year":"2009","unstructured":"Human infection with new influenza A (H1N1) virus:. Clinical observations from Mexico and other affected countries, May 2009. Wkly Epidemiol Rec, 2009; 84:185\u2013189.","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_3_1_24_2","unstructured":"Clinical management of human infection with pandemic (H1N1) 2009: Revised guidance. Geneva: World Health Organization November 2009. www.who.int\/csr\/resources\/publications\/swineflu\/clinical_management\/en\/index.html. 2010 August 24."},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.2807\/ese.14.49.19434-en"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0909049"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2344"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature08260"},{"key":"e_1_3_1_29_2","unstructured":"World Health Organization Recommended Use of Antivirals. Pandemic (H1N1 2009 briefing note 8. www.who.int\/csr\/disease\/swineflu\/notes\/h1n1_use_antivirals_20090820\/en\/index.html. 2010 August 25."},{"key":"e_1_3_1_30_2","unstructured":"World Health Organization. Clinical management of human infection with pandemic (H1N1 2009 revised guidance. www.who.int\/csr\/resources\/publications\/swineflu\/clinical_management_h1n1.pdf. 2010 August 25."},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61528-2"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0910893"},{"key":"e_1_3_1_33_2","first-page":"37","article-title":"Update on oseltamivir-resistant pandemic A (H1N1) 2009 influenza virus: January 2010","volume":"85","year":"2009","unstructured":"Update on oseltamivir-resistant pandemic A (H1N1) 2009 influenza virus: January 2010. Wkly Epidemiol Rec, 2009; 85:37\u201340.","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_3_1_34_2","unstructured":"Centers for Disease Control and Prevention (CDC). Interim guidance on case definitions to be used for investigations of novel influenza A (H1N1) cases. www.dphss.guam.gov\/docs\/swine_flu\/H1N1_Guidance\/case%20def%20june%201.pdf. 2010 August 24."},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009880"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2010.00518.x"},{"key":"e_1_3_1_37_2","first-page":"67","article-title":"Pandemic influenza A (H1N1) 2009 outbreak in a residential school at Panchgani, Maharashtra, India","volume":"132","author":"Gurav YK","year":"2010","unstructured":"Gurav YK, , Pawar SD, , Chadha MS et al. Pandemic influenza A (H1N1) 2009 outbreak in a residential school at Panchgani, Maharashtra, India. Indian J Med Res, 2010; 132:67\u201371.","journal-title":"Indian J Med Res"},{"key":"e_1_3_1_38_2","first-page":"485","article-title":"Epidemiological summary of pandemic influenza A (H1N1) 2009 virus\u2014Ontario, Canada, June 2009","volume":"84","author":"World Health Organization","year":"2009","unstructured":"World Health Organization. Epidemiological summary of pandemic influenza A (H1N1) 2009 virus\u2014Ontario, Canada, June 2009. Wkly Epidemiol Rec, 2009; 84:485\u2013491.","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1086\/651145"},{"key":"e_1_3_1_40_2","first-page":"481","article-title":"Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 virus","volume":"84","year":"2009","unstructured":"Transmission dynamics and impact of pandemic influenza A (H1N1) 2009 virus. Wkly Epidemiol Rec, 2009; 84:481\u2013484.","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1583"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906695"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1536"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908481"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1496"},{"key":"e_1_3_1_46_2","first-page":"749","article-title":"Intensive-care patients with severe novel influenza A (H1N1) virus infection\u2014Michigan, June 2009","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Intensive-care patients with severe novel influenza A (H1N1) virus infection\u2014Michigan, June 2009. MMWR Morb Mortal Wkly Rep, 2009; 58:749\u2013752.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.84.6.957"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.76.4.479"},{"key":"e_1_3_1_49_2","first-page":"196A","article-title":"Prospective randomized controlled trial of conventional treatment or transport for ECMO in infants with persistent pulmonary hypertension (PPHN)","volume":"31","author":"Bifano EM","year":"1992","unstructured":"Bifano EM, , Hakanson DO, , Hingre RV, , Gross SJ. Prospective randomized controlled trial of conventional treatment or transport for ECMO in infants with persistent pulmonary hypertension (PPHN) Pediatr Res, 1992; 31:196A.","journal-title":"Pediatr Res"},{"key":"e_1_3_1_50_2","volume-title":"ECLS Registry Report","author":"Extracorporeal Life Support Organization","year":"2004","unstructured":"Extracorporeal Life Support Organization. ECLS Registry Report. Ann Arbor: University of Michigan, January 2004."},{"key":"e_1_3_1_51_2","first-page":"451","volume-title":"ECMO: Extracorporeal Cardiopulmonary Support in Critical Care","author":"Goodman DM","year":"2000","unstructured":"Goodman DM, , Green TP. Extracorporeal life support for children with acute respiratory distress syndrome. Zwischenberger JB, , Steinhorn RH, , Bartlett RH. ECMO: Extracorporeal Cardiopulmonary Support in Critical Care. Ann Arbor, Mich: Extracorporeal Life Support Organization, 2000; 451\u2013460."},{"key":"e_1_3_1_52_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03300200023016"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.2.8306022"},{"key":"e_1_3_1_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61069-2"},{"key":"e_1_3_1_55_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2006.04781.x"},{"key":"e_1_3_1_56_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197203232861204"},{"key":"e_1_3_1_57_2","first-page":"31","volume-title":"Extracorporeal Life Support","author":"Bartlett RH","year":"1993","unstructured":"Bartlett RH. The development of prolonged extracorporeal circulation. Arensman RM, , Cornish JD. Extracorporeal Life Support. Boston: Blackwell Scientific Publications, 1993; 31\u201341."},{"key":"e_1_3_1_58_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03380070087025"},{"key":"e_1_3_1_59_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2009.08.006"},{"key":"e_1_3_1_60_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1661-7"},{"key":"e_1_3_1_61_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1535"},{"key":"e_1_3_1_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-009-9253-0"},{"key":"e_1_3_1_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2021-3"},{"key":"e_1_3_1_64_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-5153.2010.00419.x"},{"key":"e_1_3_1_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2010.04.010"},{"key":"e_1_3_1_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34497-8"},{"key":"e_1_3_1_67_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-18-28"},{"key":"e_1_3_1_68_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep396"},{"key":"e_1_3_1_69_2","first-page":"741","article-title":"A case of ARDS associated with influenza A\u2013H1N1 infection treated with extracorporeal respiratory support","volume":"75","author":"Grasselli G","year":"2009","unstructured":"Grasselli G, , Foti G, , Patroniti N et al. A case of ARDS associated with influenza A\u2013H1N1 infection treated with extracorporeal respiratory support. Minerva Anestesiol, 2009; 75:741\u2013745.","journal-title":"Minerva Anestesiol"},{"key":"e_1_3_1_70_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-6646(09)60422-8"},{"key":"e_1_3_1_71_2","first-page":"381","article-title":"The first novel influenza A (H1N1) fatality despite antiviral treatment and extracorporeal membrane oxygenation in Hong Kong","volume":"15","author":"Liong T","year":"2009","unstructured":"Liong T, , Lee KL, , Poon YS et al. The first novel influenza A (H1N1) fatality despite antiviral treatment and extracorporeal membrane oxygenation in Hong Kong. Hong Kong Med J, 2009; 15:381\u2013-384.","journal-title":"Hong Kong Med J"},{"key":"e_1_3_1_72_2","first-page":"749","article-title":"Intensive-care patients with severe novel influenza A (H1N1) virus infection\u2014Michigan. June 2009","volume":"58","author":"Centers for Disease Control and Prevention (CDC)","year":"2009","unstructured":"Centers for Disease Control and Prevention (CDC). Intensive-care patients with severe novel influenza A (H1N1) virus infection\u2014Michigan. June 2009. MMWR Morb Mortal Wkly Rep, 2009; 58:749\u2013752.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_1_73_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010938"}],"container-title":["Surgical Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/sur.2010.082","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2010.082","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2010.082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:16:09Z","timestamp":1777688169000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/sur.2010.082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,4,1]]},"references-count":72,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,4,1]]}},"alternative-id":["10.1089\/sur.2010.082"],"URL":"https:\/\/doi.org\/10.1089\/sur.2010.082","relation":{},"ISSN":["1096-2964","1557-8674"],"issn-type":[{"value":"1096-2964","type":"print"},{"value":"1557-8674","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,4,1]]}}}