David Zonies1, Matthias Merkel. 1. aDepartment of Surgery, Oregon Health & Science UniversitybDepartment of Anesthesiology & Perioperative Medicine, OHSU Knight Cardiovascular Institute, Oregon Health & Science University, Oregon, USA.
Abstract
PURPOSE OF REVIEW: The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described. RECENT FINDINGS: ECLS use is increasing among trauma patients. Several recent studies among trauma patients report survival rates of 65-79%. Despite the high bleeding risk, extracorporeal membrane oxygenation (ECMO) may be safely implemented in trauma patients based on a strict protocol-driven policy. Early implementation may improve overall outcomes. Alternative anticoagulants and heparin free periods may be well tolerated in trauma patients at high risk of hemorrhage. SUMMARY: ECMO is becoming a more routine option in severely injured trauma patients that develop severe respiratory failure. Well tolerated implementation and program development is possible among regional trauma centers. Although clinical knowledge gaps exist, ECMO is a promising treatment in this high-risk population.
PURPOSE OF REVIEW: The purpose is to review the current application of extracorporeal life support (ECLS) in traumapatients. In addition, programmatic development is described. RECENT FINDINGS: ECLS use is increasing among traumapatients. Several recent studies among traumapatients report survival rates of 65-79%. Despite the high bleeding risk, extracorporeal membrane oxygenation (ECMO) may be safely implemented in traumapatients based on a strict protocol-driven policy. Early implementation may improve overall outcomes. Alternative anticoagulants and heparin free periods may be well tolerated in traumapatients at high risk of hemorrhage. SUMMARY: ECMO is becoming a more routine option in severely injured traumapatients that develop severe respiratory failure. Well tolerated implementation and program development is possible among regional trauma centers. Although clinical knowledge gaps exist, ECMO is a promising treatment in this high-risk population.
Authors: Jay Menaker; Ronald B Tesoriero; Ali Tabatabai; Ronald P Rabinowitz; Christopher Cornachione; Terence Lonergan; Katelyn Dolly; Raymond Rector; James V O'Connor; Deborah M Stein; Thomas M Scalea Journal: World J Surg Date: 2018-08 Impact factor: 3.352
Authors: David Zonies; Panna Codner; Pauline Park; Niels D Martin; Matthew Lissauer; Susan Evans; Christine Cocanour; Karen Brasel Journal: Trauma Surg Acute Care Open Date: 2019-04-03