2012 Pandemic Flu

Dear Editor, a new H1N1 pandemic flu is approaching Europe. In Italy, the results obtained from the “ECMOnet” network, for the centralization of patients with adult respiratory distress syndrome (ARDS) in structures with extracorporeal membrane oxygenation (ECMO) support, are encouraging (1,2) but far from being exhaustive, mainly because of the small number of patients treated. The ECMO technique seems to be successful (3), and probably represents the turning point for patients affected by a respiratory failure considered, until recently, irrecoverable. Moreover, the key role of extracorporeal life support in severe hemodynamic failure, not responding to conventional therapy, is already established, and a more extensive use of ECMO is recommended. Despite the attention that the technique has received during the previous Italian pandemic, many physicians do not know the criteria for patients centralization and therapy establishment. This could lead to an higher than expected failure rate due to late or missed patients centralization. More efforts are therefore needed to establish the enrollment criteria and to spread their knowledge among clinicians involved in patients’ recruitment. We would be very grateful if you could publish the enrollment criteria, shared by your trustworthy board, to publicize this data among the Italian ICUs. This could help to improve survival of patients with adult respiratory distress syndrome (ARDS) not only during the pandemic, but also during the rest of the year.