{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T14:59:04Z","timestamp":1760799544691},"reference-count":38,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,10,1]]},"abstract":"<jats:p>The most common cause of death due to the H1N1 subtype of influenza A virus (swine flu) in the 2009 to 2010 epidemic was severe acute respiratory failure that persisted despite advanced mechanical ventilation strategies. Extracorporeal membrane oxygenation (ECMO) was used as a salvage therapy for patients refractory to traditional treatment. At Legacy Emanuel Hospital, Portland, Oregon, the epidemic resulted in a critical care staffing crisis. Among the 15 patients with H1N1 influenza A treated with ECMO, 4 patients received the therapy simultaneously. The role of ECMO in supporting patients with severe respiratory failure due to H1N1 influenza is described, followed by discussions of the nursing care challenges for each body system. Variations from standards of care, operational considerations regarding staff workload, institutional burden, and emotional wear and tear of the therapy on patients, patients\u2019 family members, and the entire health care team are also addressed. Areas for improvement for providing care of the critically ill patient requiring ECMO are highlighted in the conclusion.<\/jats:p>","DOI":"10.4037\/ccn2011186","type":"journal-article","created":{"date-parts":[[2011,10,1]],"date-time":"2011-10-01T07:18:17Z","timestamp":1317453497000},"page":"e8-e24","source":"Crossref","is-referenced-by-count":9,"title":["Critically Ill Patients With H1N1 Influenza A Undergoing Extracorporeal Membrane Oxygenation"],"prefix":"10.4037","volume":"31","author":[{"given":"Christopher","family":"Bibro","sequence":"first","affiliation":[{"name":"Christopher Bibro received a BSN from the University of Maryland, Baltimore, in 2001. He has worked in the West Wing intensive care unit since 2004."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Lasich","sequence":"additional","affiliation":[{"name":"Christine Lasich received a BSN from the University of Portland, Oregon, in 2003. She has worked in the Legacy Emanuel Hospital since 2000 and in the West Wing intensive care unit since 2003."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Frank","family":"Rickman","sequence":"additional","affiliation":[{"name":"Frank D. Rickman, Jr, received a BSN in 2002 from the University of Texas, School of Nursing, Houston. He has worked in the West Wing intensive care unit since 2003."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichole E.","family":"Foley","sequence":"additional","affiliation":[{"name":"Nichole E. Foley received an AND from the University of South Dakota, Vermillion, in 2003 and a BSN from South Dakota State University, Brookings, in 2009. She has worked as a staff nurse in the West Wing intensive care unit since 2007."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujen K.","family":"Kunugiyama","sequence":"additional","affiliation":[{"name":"Sujen K. Kunugiyama received a BSN from Linfield College, Portland, Oregon. She has worked in the trauma recovery acute care unit and the West Wing intensive care unit since 2005."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ember","family":"Moore","sequence":"additional","affiliation":[{"name":"Ember Moore received an ASN from Kettering College of Medical Arts, Dayton, Ohio, in 2005. She has worked in the West Wing intensive care unit since 2008."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Amy O\u2019Brien received an AND from Portland Community College, Portland, Oregon, in 2005 and has worked in the West Wing intensive care unit since then."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Sherman","sequence":"additional","affiliation":[{"name":"Natalie Sherman graduated from Seattle Pacific University, Seattle, Washington, in 2004 and worked in the West Wing intensive care unit for 3 years. She is currently pursuing her CRNA degree at Kaiser Permanente School of Anesthesia, Pasadena, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine S.","family":"Schulman","sequence":"additional","affiliation":[{"name":"Christine S. Schulman is the clinical nurse specialist for the West Wing intensive care unit and the East intensive care unit at Legacy Emanuel Hospital. She also works as an independent consultant for trauma and critical care nursing throughout the Pacific Northwest region and nationally."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"issue":"25","key":"2019112521530631200_b1-03100e8","first-page":"2605","article-title":"Emergence of a novel swine-origin influenza A (H1N1) virus in humans [published correction appears in N Engl J Med. 2009;361(1):102]","volume":"360","author":"Novel Swine-Origin Influenza (H1N1) Virus Investigation Team","year":"2009","journal-title":"N Engl J Med."},{"issue":"5037","key":"2019112521530631200_b2-03100e8","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1126\/science.1176225","article-title":"Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans","volume":"325","author":"Garten","year":"2009","journal-title":"Science."},{"key":"2019112521530631200_b3-03100e8","unstructured":"World Health Organization. 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