title: Application of ECMO in multitrauma patients with ARDS as rescue therapy.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Cologne University Hospital, Cologne, Germany. navid.madershaian@web.de
authors.forename: Navid
authors.initials: N
authors.lastname: Madershahian
authors.forename: Thorsten
authors.initials: T
authors.lastname: Wittwer
authors.forename: Justus
authors.initials: J
authors.lastname: Strauch
authors.forename: Ulrich F W
authors.initials: UF
authors.lastname: Franke
authors.forename: Jens
authors.initials: J
authors.lastname: Wippermann
authors.forename: Mirko
authors.initials: M
authors.lastname: Kaluza
authors.forename: Thorsten
authors.initials: T
authors.lastname: Wahlers
mesh_terms: 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