Extracorporeal Membrane Oxygenation in the Treatment of Novel Influenza Virus Infection: A Multicentric Hospital-Based Health Technology Assessment in Lombardy Region

Lago, P.; Vallone, I.; Zarola, G.

ECMO or Extracorporeal Membrane Oxygenation is a specialized heart-lung bypass machine used to take over the body’s heart and lung function while the body heals from injury or illness. One of the disturbing hallmarks of the novel A/H1N1 flu virus is that it produces severe lung damage resulting in ARDS (Acute Respiratory Distress Syndrome). Normally, patients with ARDS are placed on mechanical ventilation in Intensive Care Units (ICUs) and treated with a variety of pharmacological agents to reduce infection and lung inflammation. With A/H1N1 viral pneumonia, mechanical ventilation often does not result in adequate oxygenation so with ECMO the burden of pumping and oxygenating the blood is taken from the heart and lungs, and they are given time to heal. San Matteo Polyclinic Hospital was nominated by the Lombardy Region and the Ministry of Health as national reference for the installation of ECMO to deal severe heart failure and pulmonary caused by novel A/H1N1 flu virus. Clinical Engineering Department of the hospital had a fundamental coordination role in biomedical technology-related issues. It supported high-level management decisions (strategy, management, planning, procurement and maintenance) to answer to Lombardy’s guidelines about the organization of ECMO machines in the region. Moreover it had an important role in the assessment, by the use of HTA procedures, of ECMO alternative technologies.