The purpose of this descriptive study was to characterize the utilization and outcomes of CPB after trauma.

This is an AAST-sponsored retrospective (2011-2021) multicenter (32 centers) study of all adult trauma patients undergoing CPB. Univariate analysis comparing demographics, clinical characteristics and the study outcomes were performed between those who required CPB≤2 hours, >2-24 hours, and >24 hours from the arrival. The primary outcome was mortality.

There were 113 patients, 63% sustained blunt trauma. The most common injuries were cardiac (42%), thoracic aorta (42%), and pericardial tamponade (25%). The three most common reasons to use CPB were aortic repair (32%), cardiopulmonary resuscitation (20%), and cardiac repair (15%). CPB was performed within 2 hours in 44(39%), and 21(19%) underwent CPB after 24-hours. Penetrating mechanisms of injury 24 (55%) (P = .009), higher rate of hypotension (SBP <80 mmHg) 15 (71%) (P = .002) were more common in CPB≤2-hours. Septal (P = .001) and valvular (P = .002) injuries were more frequent in CPB >24 hours, otherwise there were no differences in injury patterns among CPB ≤2 hours, >2-24 hours, and >24 hours. Cardiac repair was the most common indications for CPB ≤2 hours (P = .002), aorta repair was more common in CPB 2-24 hours (P = .03). Complications were not different between CPB ≤2 hours, >2-24 hours, and >24 hours. Among survivors, no differences in terms of discharge disposition, hospital LOS were found (all P > .05). Mortality was 22% with 96% of them undergoing CPB in the first 24 hours (P < .001).

CPB is rarely used for traumatic injuries. The true impact of CPB is unknown and should be studied in comparison to patients with cardiovascular injuries that are repaired without CPB.