Extracorporeal Membrane Oxygenation (ECMO) in Trauma

Abstract

Patients with traumas and associated cardiopulmonary failure have a high mortality rate; in such patients, the use of extracorporeal membrane oxygenation (ECMO) may grant patient’s tissue perfusion supporting cardiac and respiratory functions in traumatic lung injuries who do not respond to conventional mechanical ventilation and other treatments: chemical paralysis, prone positioning, inhaled prostacyclins, and pressure-controlled inverse ratio ventilation. When all these treatment provisions are not adequate, and lung compliance becomes worse, the increased inspiratory pressures may cause barotrauma and further impaired lung function. Nevertheless, trauma patients may present acute heart failure, e.g., due to a serious bleeding, stunned heart following direct trauma (severe contusion and hematoma), or depression determined by acidosis and hypothermia. The clinical use of ECMO, providing a bridge to rescue therapy, is becoming increasingly frequent showing a dramatic improvement in survival rate or allowing organ donation after cardiac death.