Flu hitting adults hard, ECMO treatment helped save one man’s life

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KANSAS CITY, Mo. -- Doctors say the flu is hitting some young and middle-aged adults very hard.  The H1N1 strain circulating this season seems to be especially dangerous for them.  St. Luke's Hospital has had eight patients in the last month who were critically ill with respiratory failure.

CJ Mandacina remembers nothing between Thanksgiving and Christmas.

"It doesn't seem real.  It seems like a story from somebody else," said Mandacina.

Mandacina's loved ones thought the story was going to end with his death from pneumonia.  Doctors suspect the pneumonia resulted from H1N1 flu.

"Was at a point where had he not come to St. Luke's and been put on ECMO, he would not have made it," said his sister, Maria Martinez.

ECMO is a sophisticated artificial lung for those in respiratory failure.  The machine removed Mandacina's blood, oxygenated it and returned it to his body.  That was after a ventilator, even on the highest setting, wasn't helping.

"That can also injure the lung on its own, so ECMO is a way to support the lungs fully without the use of the ventilator. It allows the lungs to rest and recover until the pneumonia can clear and the body can recover," said Dr. Michelle Haines, a specialist in critical care medicine.

St. Luke's is one of three metro hospitals that have ECMO programs.  Children's Mercy and KU Med are the others.  That raises the question of whether there are enough ECMO machines if cases continue to rise.  At one point in recent weeks, St. Luke's had all four of its regular machines in use although it also has a back-up.  Dr. Haines said the hospital could get more machines if needed.

"We're getting more of our nurses trained in ECMO support in case we have more patients come in," said Dr. Haines.

The doctor said there isn't a lot of published data showing the benefit of ECMO, but at St. Luke's, 70 percent of the patients put on it survive.  She said their chances of death were higher than 80 percent prior to ECMO treatment.

"Besides the limited movement, I feel fine," said Mandacina.

Therapy should help him get movement back.

"I'm amazed.  It's pretty emotional.  He's a miracle, he really is," said Martinez.

Mandacina's caregivers said his story is a reminder to get your flu shot, and if you get sick, don't wait to get help until you have trouble breathing.  That could be too late.

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