Traumatic respiratory failure and veno-venous extracorporeal membrane oxygenation support.

Autor: Salas De Armas IA; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Akkanti B; Division of Pulmonary, Critical Care and Sleep Medicine, UTHealth, Houston, TX, USA., Doshi PB; Division of Pulmonary, Critical Care and Sleep Medicine, UTHealth, Houston, TX, USA.; Department of Emergency Medicine, UTHealth, Houston, TX, USA., Patel M; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Kumar S; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Akay MH; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Hussain R; Division of Pulmonary, Critical Care and Sleep Medicine, UTHealth, Houston, TX, USA., Dinh K; Division of Pulmonary, Critical Care and Sleep Medicine, UTHealth, Houston, TX, USA., Baloch MY; Division of Pulmonary, Critical Care and Sleep Medicine, UTHealth, Houston, TX, USA., Ahmed MS; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Banjac I; Department of Emergency Medicine, UTHealth, Houston, TX, USA., Jumean MF; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., McGinness K; Cardiovascular Perfusion Program, UTHealth, Houston, TX, USA., Janowiak LM; Department of Emergency Medicine, UTHealth, Houston, TX, USA., Mittal Agrawal K; Department of General Surgery, UTHealth, Houston, TX, USA., Nathan S; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Zaki J; Department of Anesthesia, UTHealth, Houston, TX, USA., Nieto L; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Klein K; Department of Pathology and Laboratory Medicine, UTHealth, Houston, TX, USA., Taub E; Division of Acute Care Surgery, Trauma & Critical Care, UTHealth, Houston, TX, USA., Tint H; Department of Pathology and Laboratory Medicine, UTHealth, Houston, TX, USA., Patel JA; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Nascimbene A; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Kar B; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA., Gregoric ID; Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
Jazyk: angličtina
Zdroj: Perfusion [Perfusion] 2022 Jul; Vol. 37 (5), pp. 477-483. Date of Electronic Publication: 2021 Apr 30.
DOI: 10.1177/02676591211012840
Abstrakt: Background: Respiratory failure (RF) is a common cause of death and morbid complication in trauma patients. Extracorporeal membrane oxygenation (ECMO) is increasingly used in adults with RF refractory to invasive mechanical ventilation. However, use of ECMO remains limited for this patient population as they often have contraindications for anticoagulation.
Study Design: Medical records were retroactively searched for all adult patients who were admitted to the trauma service and received veno-venous ECMO (VV ECMO) support between June 2015 and August 2018. Survival to discharge and ECMO-related complications were collected and analyzed.
Results: Fifteen patients from a large Level I trauma center met the criteria. The median PaO 2 /FiO 2 ratio was 53.0 (IQR, 27.0-76.0), median injury severity score was 34.0 (IQR, 27.0-43.0), and the median duration of ECMO support was 11 days (IQR, 7.5-20.0). For this cohort, the survival-to-discharge rate was 87% (13/15). The incidence of neurologic complications was 13%, and deep vein thrombosis was reported in two cases (13%).
Conclusions: Survival rates of trauma patients in this study are equivalent to, or may exceed, those of non-trauma patients who receive ECMO support for other types of RF. With the employment of a multidisciplinary team assessment and proper patient selection, early cannulation, traumatic RF may be safely supported with VV ECMO in experienced centers.
Databáze: MEDLINE
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