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Veno-Venous Extracorporeal Membrane Oxygenation (VV ECMO) for Acute Respiratory Failure Following Injury: Outcomes in a High-Volume Adult Trauma Center with a Dedicated Unit for VV ECMO.
Menaker, Jay; Tesoriero, Ronald B; Tabatabai, Ali; Rabinowitz, Ronald P; Cornachione, Christopher; Lonergan, Terence; Dolly, Katelyn; Rector, Raymond; O'Connor, James V; Stein, Deborah M; Scalea, Thomas M.
Afiliação
  • Menaker J; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA. jmenaker@umm.edu.
  • Tesoriero RB; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Tabatabai A; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Rabinowitz RP; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Cornachione C; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Lonergan T; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Dolly K; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Rector R; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • O'Connor JV; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Stein DM; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
  • Scalea TM; Program in Trauma, R Adams Cowley Shock Trauma Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
World J Surg ; 42(8): 2398-2403, 2018 08.
Article em En | MEDLINE | ID: mdl-29340723
ABSTRACT

INTRODUCTION:

The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) has increased over the past decade. The purpose of this study was to evaluate outcomes in adult trauma patients requiring VV ECMO.

METHODS:

Data were collected on adult trauma patients admitted between January 1, 2015, and November 1, 2016. Demographics, injury-specific data, ECMO data, and survival to discharge were recorded. Medians [interquartile range (IQR)] were reported. A p value ≤0.05 was considered statistically significant.

RESULTS:

Eighteen patients required VV ECMO during the study period. Median age was 28.5 years (IQR 24-43). Median injury severity score (ISS) was 27 (IQR 21-41); median PaO2/FiO2 (P/F) prior to ECMO cannulation was 61 (IQR 50-70). Median time from injury to cannulation was 3 (IQR 0-6) days. Median duration of ECMO was 266 (IQR 177-379) hours. Survival to discharge was 78%. Survivors had a significantly higher ISS (p = 0.03), longer intensive care unit length of stay (ICU LOS) (p < 0.0004), hospital LOS (p < 0.000004), and time on the ventilator (p < 0.0003). Median time of injury to cannulation was significantly longer in patients who survived to discharge (p = 0.01). There was no difference in P/F ratio prior to cannulation (p = ns).

CONCLUSION:

We have demonstrated improved outcome of patients requiring VV ECMO following injury compared to historical data. Although shorter time from injury to cannulation for VV ECMO was associated with death, select patients who meet criteria for VV ECMO early following injury should be referred/transferred to a tertiary care facility that specializes in trauma and ECMO care.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Insuficiência Respiratória / Oxigenação por Membrana Extracorpórea Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome do Desconforto Respiratório / Insuficiência Respiratória / Oxigenação por Membrana Extracorpórea Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article