Craniotomy during ECMO in a severely traumatized patient.
Extracorporeal membrane oxygenation (ECMO) can be a last resort treatment in acute respiratory distress syndrome after thoracic trauma. However, co-existent brain trauma is considered to be a contra-indication for ECMO. This is the first report on successful craniotomy under ECMO treatment in a multiply traumatized patient with severe thoracic and brain injuries. This successful treatment with beneficial neurological outcome suggests that ECMO therapy should not be withheld from severely injured patients with combined brain and thoracic trauma presenting with life-threatening hypoxemia. Moreover, even craniotomy may be performed during ECMO therapy without major bleeding and adverse effects on neurological function.
Friesenecker
B E
BE
Department of Anaesthesiology and Critical Care Medicine, Division of General and Surgical Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria. Barbara.Friesenecker@uibk.ac.at
Peer
R
R
Rieder
J
J
Lirk
P
P
Knotzer
H
H
Hasibeder
W R
WR
Mayr
A J
AJ
Dünser
M W
MW
D000058:Accidental Falls; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000592:standards; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D020202:Cerebral Hemorrhage, Traumatic / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D003399:Craniotomy / Q000592:standards*; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D055370:Lung Injury; D008297:Male; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013898:Thoracic Injuries / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants