Advanced extracorporeal therapy in trauma.
The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described.



ECLS use is increasing among trauma patients. Several recent studies among trauma patients report survival rates of 65-79%. Despite the high bleeding risk, extracorporeal membrane oxygenation (ECMO) may be safely implemented in trauma patients based on a strict protocol-driven policy. Early implementation may improve overall outcomes. Alternative anticoagulants and heparin free periods may be well tolerated in trauma patients at high risk of hemorrhage.



ECMO is becoming a more routine option in severely injured trauma patients that develop severe respiratory failure. Well tolerated implementation and program development is possible among regional trauma centers. Although clinical knowledge gaps exist, ECMO is a promising treatment in this high-risk population.
aDepartment of Surgery, Oregon Health & Science UniversitybDepartment of Anesthesiology & Perioperative Medicine, OHSU Knight Cardiovascular Institute, Oregon Health & Science University, Oregon, USA.
David
D
Zonies
Matthias
M
Merkel
D000925:Anticoagulants / Q000627:therapeutic use; D016638:Critical Illness; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods* / Q000639:trends; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012771:Shock, Hemorrhagic / Q000628:therapy; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*
D000925:Anticoagulants; D006493:Heparin