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Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO).
Injury. 2006 Jan; 37(1):29-32.I

Abstract

BACKGROUND

Conventional mechanical ventilation is the mainstay of treatment for severe respiratory failure associated with trauma. However, when extensive lung injury is present, this technique may not be sufficient to prevent hypoxia, and furthermore, may exacerbate pulmonary damage by barotrauma. Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill adult trauma patients and can offer an additional treatment modality. This study reports the use of ECMO in a cohort of adults referred with severe respiratory failure following trauma.

METHODS

Retrospective analysis over an 8-year period of all 28 adult patients referred to a single tertiary unit for ECMO support. Survival relative to Injury severity score (ISS), lung injury score (Murray grade), duration of treatment and patient age was evaluated.

RESULTS

Twenty of 28 patients who received ECMO with severe trauma related respiratory failure (mean PaO2/FiO2 of 62 mmHg) survived. Most patients had long bone fractures, blunt chest trauma, or combined injuries. Lung injury and injury severity scores, patient age, ECMO duration and oxygenation indices pre-ECMO (PaO2/FiO2) were similar in both the survivor and non-survivor groups.

CONCLUSION

A high proportion of trauma patients treated with ECMO for severe lung injury survived. This outcome appears to compare favourably to conventional ventilation techniques and may have a role in patients who develop acute severe respiratory distress associated with trauma.

Authors+Show Affiliations

Heartlink ECMO Centre, The Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. mailto:jamescordellsmith@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16243331

Citation

Cordell-Smith, J A., et al. "Traumatic Lung Injury Treated By Extracorporeal Membrane Oxygenation (ECMO)." Injury, vol. 37, no. 1, 2006, pp. 29-32.
Cordell-Smith JA, Roberts N, Peek GJ, et al. Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO). Injury. 2006;37(1):29-32.
Cordell-Smith, J. A., Roberts, N., Peek, G. J., & Firmin, R. K. (2006). Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO). Injury, 37(1), 29-32.
Cordell-Smith JA, et al. Traumatic Lung Injury Treated By Extracorporeal Membrane Oxygenation (ECMO). Injury. 2006;37(1):29-32. PubMed PMID: 16243331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO). AU - Cordell-Smith,J A, AU - Roberts,N, AU - Peek,G J, AU - Firmin,R K, Y1 - 2005/10/21/ PY - 2004/06/09/received PY - 2005/03/24/revised PY - 2005/03/24/accepted PY - 2005/10/26/pubmed PY - 2006/5/31/medline PY - 2005/10/26/entrez SP - 29 EP - 32 JF - Injury JO - Injury VL - 37 IS - 1 N2 - BACKGROUND: Conventional mechanical ventilation is the mainstay of treatment for severe respiratory failure associated with trauma. However, when extensive lung injury is present, this technique may not be sufficient to prevent hypoxia, and furthermore, may exacerbate pulmonary damage by barotrauma. Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill adult trauma patients and can offer an additional treatment modality. This study reports the use of ECMO in a cohort of adults referred with severe respiratory failure following trauma. METHODS: Retrospective analysis over an 8-year period of all 28 adult patients referred to a single tertiary unit for ECMO support. Survival relative to Injury severity score (ISS), lung injury score (Murray grade), duration of treatment and patient age was evaluated. RESULTS: Twenty of 28 patients who received ECMO with severe trauma related respiratory failure (mean PaO2/FiO2 of 62 mmHg) survived. Most patients had long bone fractures, blunt chest trauma, or combined injuries. Lung injury and injury severity scores, patient age, ECMO duration and oxygenation indices pre-ECMO (PaO2/FiO2) were similar in both the survivor and non-survivor groups. CONCLUSION: A high proportion of trauma patients treated with ECMO for severe lung injury survived. This outcome appears to compare favourably to conventional ventilation techniques and may have a role in patients who develop acute severe respiratory distress associated with trauma. SN - 0020-1383 UR - https://www.unboundmedicine.com/medline/citation/16243331/Traumatic_lung_injury_treated_by_extracorporeal_membrane_oxygenation__ECMO__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-1383(05)00278-0 DB - PRIME DP - Unbound Medicine ER -