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Advanced extracorporeal therapy in trauma

Zonies, David; Merkel, Matthias

Current Opinion in Critical Care: December 2016 - Volume 22 - Issue 6 - p 578–583
doi: 10.1097/MCC.0000000000000366
TRAUMA: Edited by Kjetil Sunde and Christina Gaarder
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Purpose of review The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described.

Recent findings 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.

Summary 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 University

bDepartment of Anesthesiology & Perioperative Medicine, OHSU Knight Cardiovascular Institute, Oregon Health & Science University, Oregon, USA

Correspondence to David Zonies, MD, MPH, Division of Trauma, Critical Care, & Acute Care Surgery, Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, L611, Portland, OR 97239, USA. Tel: +1 503 494 5300; fax: +1 503 494 6519; e-mail: zonies@ohsu.edu

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