Application of ECMO in multitrauma patients with ARDS as rescue therapy.
BACKGROUND
Despite recent advances in critical care management, the mortality of acute respiratory distress syndrome (ARDS) remains high. The final rescue therapy for patients with severe hypoxia refractory to conventional therapy modalities is the extracorporeal gas exchange.


METHODS
We report the management of three polytraumatized patients with life-threatening injuries, severe blunt thoracic trauma, and consecutive ARDS treating by extracorporeal membrane oxygenation (ECMO). Two patients suffered a car accident with severe lung contusion and parenychmal bleeding. Bronchial rupture and mediastinal emphysema was found in one of them. Another patient developed ARDS after attempted suicide with multiple fractures together with blunt abdominal and thoracic trauma.


RESULTS
All patients were placed on ECMO and could be rapidly stabilized. They were weaned from ECMO after a mean of 114 +/- 27 hours of support without complications, respectively. Mean duration of ICU stay was 37 +/- 23 days.


CONCLUSIONS
Quick encouragement of ECMO for the temporary management of gas exchange may increase survival rates in trauma patients with ARDS.
Madershahian
Navid
N
Department of Cardiothoracic Surgery, Cologne University Hospital, Cologne, Germany. navid.madershaian@web.de
Wittwer
Thorsten
T
Strauch
Justus
J
Franke
Ulrich F W
UF
Wippermann
Jens
J
Kaluza
Mirko
M
Wahlers
Thorsten
T
D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D008297:Male; D009104:Multiple Trauma / Q000150:complications*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*; D013898:Thoracic Injuries / Q000150:complications; D014949:Wounds, Nonpenetrating