Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO)

J. A. Cordell-Smith, N. Roberts, G. J. Peek, R. K. Firmin

Research output: Contribution to journalArticle

84 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)29-32
Number of pages4
JournalInjury
Volume37
Issue number1
DOIs
StatePublished - Jan 2006

Keywords

  • ARDS
  • Acute lung injury
  • ECMO
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

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    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. https://doi.org/10.1016/j.injury.2005.03.027