Venovenous extracorporeal life support for posttraumatic respiratory distress syndrome in adults: the risk of major hemorrhages

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Chung-Chi Huang¹  Hsuan-Ling Hsiao³  Kuo-Chin Kao¹  Yuan-His Tseng²  Pyng-Jing Lin²  Meng-Yu Wu² 

[1] Department of Respiratory Therapy, Chang Gung Memorial Hospital and Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan 333, Taiwan;Department of Cardiovascular Surgery, Chang Gung Memorial Hospital and Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan 333, Taiwan;Department of Clinical Pharmacy, Chang Gung Memorial Hospital and Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan 333, Taiwan

关键词: Heparin-minimized strategy;    Blunt chest trauma;    Posttraumatic acute respiratory distress syndrome;    Extracorporeal membrane oxygenation;    Extracorporeal life support;   

Others  :  1151922
DOI  :  10.1186/s13049-014-0056-0

 received in 2014-03-22, accepted in 2014-09-07,  发布年份 2014

【 摘 要 】

Background

The aim of this retrospective study is to investigate the therapeutic benefits and the bleeding risks of venovenous extracorporeal life support (VV-ECLS) when used for adult posttraumatic respiratory distress syndrome (posttraumatic ARDS).

Materials and methods

Twenty adult trauma patients (median age: 38 years, median injury severity score: 35) treated with VV-ECLS in a level I trauma center between January 2004 and June 2013 were enrolled in this study. The indication of VV-ECLS for posttraumatic ARDS was refractory hypoxemia (P_aO₂/F_iO₂ ratio???70 mmHg) under advanced mechanical ventilation. To minimize potential complications, a protocol-guided VV-ECLS was adopted.

Results

Sixteen patients were weaned off VV-ECLS, and of these patients fourteen survived. Medians of the trauma-to-ECLS time, the pre-ECLS mechanical ventilation, and the ECLS duration in all patients were 64, 45, and 144 hours respectively. The median P_aO₂/F_iO₂ ratio was improved significantly soon after VV-ECLS, from 56 to 106 mmHg (p?p?=?0.02; 95% CI: 2¿239; c-index: 0.81).

Conclusions

Despite an effective respiratory support, VV-ECLS should be cautiously administered to patients who develop advanced ARDS soon after major trauma.

【 授权许可】

   
2014 Wu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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