title: Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review.
abstract: Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonary contusion and other organ hemorrhage because of systemic anticoagulation during the treatment. We herein report a patient who successfully survive a multitrauma combining pulmonary contusion and grade IV liver laceration using non-heparinized venovenous extracorporeal membrane oxygenation (vv-ECMO). The associated literature were reviewed.
authors.affiliation: General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Trauma Division, Surgery Department, Changhua Christian Hospital, 500 No. 135, Nanxiao Street, Changhua City, Taiwan ; Surgery Department, Cishan Hospital, 84247 No. 60, Zhongxue Rd., Cishan District, Kaohsiung City, Taiwan.
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Wen
authors.affiliation: General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Trauma Division, Surgery Department, Changhua Christian Hospital, 500 No. 135, Nanxiao Street, Changhua City, Taiwan.
authors.forename: Wai Hung
authors.initials: WH
authors.lastname: Chan
authors.affiliation: Cardiovascular Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan.
authors.forename: Ying-Cheng
authors.initials: YC
authors.lastname: Chen
authors.affiliation: General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Transplant Medicine and Surgery Research Centre, Changhua Christian Hospital, Changhua City, Taiwan.
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
authors.affiliation: General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Trauma Division, Surgery Department, Changhua Christian Hospital, 500 No. 135, Nanxiao Street, Changhua City, Taiwan.
authors.forename: Chien-Pin
authors.initials: CP
authors.lastname: Chan
authors.affiliation: Transplant Medicine and Surgery Research Centre, Changhua Christian Hospital, Changhua City, Taiwan.
authors.forename: Ping-Yi
authors.initials: PY
authors.lastname: Lin
keywords: Acute pulmonary contusion; ECMO; Heparin-free; Internal bleeding; Polytraumatic