Use of Extracorporeal Membrane Oxygenation in Blunt Traumatic Injury Patients with Acute Respiratory Distress Syndrome
Abstract
Venovenous extracorporeal membrane oxygenation (VV ECMO) is commonly used to support patients with severe respiratory failure with adequate cardiac function by providing gas exchange while allowing for lung-protection, lung ventilation or pulmonary rest. In the setting of trauma, pulmonary contusion, aspiration, and pulmonary embolism can commonly impair pulmonary function. This (ECMO) can provide a temporary measure of support while awaiting pulmonary recovery. Venoarterial (VA) ECMO is often used to support patients with cardiopulmonary failure who require hemodynamic support such as myocarditis, blunt cardiac injury, large pulmonary embolus, and cardiac ischemia. Extracorporeal membrane oxygenation use may lead to various complications primarily related to bleeding or thromboembolism, as well as infections. Blunt traumatic injury is often associated with pulmonary contusions which can lead to acute respiratory distress syndrome (ARDS) in 6–25% of blunt trauma patients.1,2 Some cases of ARDS may require cardiopulmonary support in the form of ECMO.3 We describe here a series of trauma patients requiring ECMO support and their hospital outcomes between years 2016 and 2019 from a single level 1 trauma hospital that provides ECMO support to ~50 patients/y (60% VV ECMO).