The Feasibility of Venovenous ECMO at Role-2 Facilities in Austere Military Environments
| Autor: | Michael McShane, Matthew Bacchetta, Kenneth L Wilson, Tareq Maraqa, Mohamed Mohamed |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male ARDS medicine.medical_specialty Resuscitation medicine.medical_treatment Acute respiratory distress Sepsis 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Blast Injuries medicine Extracorporeal membrane oxygenation Humans 030212 general & internal medicine Blast lung Intensive care medicine business.industry Public Health Environmental and Occupational Health Afghanistan 030208 emergency & critical care medicine General Medicine Lung Injury medicine.disease Military personnel Military Personnel Accidental Feasibility Studies business |
| Zdroj: | Military medicine. 183(9-10) |
| ISSN: | 1930-613X |
| Popis: | Introduction Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion. The patient underwent immediate damage control laparotomy. The abdomen was left open for subsequent washouts and ongoing resuscitation. Due to his ineligibility for evacuation and worsening ARDS, despite 5 d of conventional ventilation strategies, he was started on VV-ECMO. The patient had immediate improvements in oxygenation, which continued for 10 d. Moreover, he underwent three transportations to the operating room without accidental decannulation or disruption of the VV-ECMO device. Despite significant improvements, the patient expired on postoperative day 15, due to an overwhelming intra-abdominal sepsis. Conclusion As future advancements are sought, VV-ECMO may become a consideration for casualties with severe ARDS at the point of injury and at lower echelons of military care. |
| Databáze: | OpenAIRE |
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