Background: Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respiratory distress syndrome (ARDS) have a high risk of bleeding during this procedure. This study aimed to determine the safety and feasibility of ECMO in patients with traumatic ARDS.
Methods: We retrospectively reviewed medical records and investigated the clinical outcomes of ECMO in 42 patients with traumatic ARDS, among whom near-drowning (42.9%) was the most frequent cause of injury.
Results: Thirty-four of 42 patients (81%) survived and were discharged after a median hospital stay of 23 days. A multivariate analysis identified a lactate level (odds ratio: 1.493, 95% confidence interval: 1.060-2.103, P = 0.022) and veno-venous (VV) ECMO (odds ratio: 0.075, 95% confidence interval: 0.006-0.901, P = 0.041) as favorable independent predictors of survival in patients with traumatic ARDS who underwent ECMO. The optimal cut off value for pre-ECMO lactate level was 10.5 mmol/L (area under the curve = 0.929, P = 0.001). In Kaplan-Meier analysis, the survival rate at hospital discharge was significant higher among the patients with a pre-ECMO lactate level of 10.5 mmol/L or less compared with patients with pre-ECMO lactate level greater than 10.5 mmol/L (93.8% versus 40.0%, respectively; P = 0.01).
Conclusions: ECMO yielded excellent survival outcomes, particularly in patients with low pre-treatment lactate levels who received VV ECMO. Therefore, ECMO appears safe and highly feasible in a carefully selected population of trauma patients.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245644 | PMC |
| http://dx.doi.org/10.1186/s13049-020-00733-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
An Unexpected Case of Generalized Tetanus.
Cureus
December 2024
Intensive Care Unit, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.
Tetanus is a disease of the nervous system caused by a toxin produced by , an anaerobe found in high concentrations in the soil. The occurrence of tetanus is related to contaminated traumatic wounds, and most patients have had some failure in their immunization. However, there are rare case reports of generalized tetanus in patients with proper vaccination schemes who failed to receive appropriate prophylaxis after high-risk exposure.
View Article and Find Full Text PDFSecondary insults prevalence, co-occurrence and relationship with outcome after severe TBI.
Brain Spine
February 2024
Brain Physics Laboratory Division of Neurosurgery Department of Clinical Neurosciences, University of Cambridge, UK.
Introduction: Secondary insults due to high intracranial pressure (ICP), low cerebral perfusion pressure (CPP) and impaired cerebral pressure reactivity (PRx) predict outcome after severe traumatic brain injury (TBI).
Research Question: What is the prevalence, co-occurrence and prognostic importance of secondary insults due to deranged ICP, CPP or PRx after TBI.
Material And Methods: Severe TBI patients requiring ICP monitoring were included.
Diagnostic Accuracy of S100B in Predicting Intracranial Abnormalities on CT Imaging Following Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis.
Neurocrit Care
January 2025
Department of Neurosurgery, University of Florida, Gainesville, FL, USA.
Traumatic brain injury (TBI) is a major cause of health loss and disabilities globally, burdening health care systems. Mild TBI is a common cause of emergency department visits. Computed tomography (CT) scans are the mainstay for acute TBI imaging.
View Article and Find Full Text PDFMetabolic disorders after traumatic brain injury: a narrative review of systemic consequences.
Metab Brain Dis
January 2025
Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil.
Traumatic brain injury (TBI) is characterized as a heterogeneous and pathological remodeling of brain physiology because of various external mechanisms, including blows, falls, and rapid acceleration and deceleration of the skull. Its pathophysiology consists of two distinct moments, beginning with a primary lesion resulting from the impact that evolves into a secondary lesion as biochemical and molecular mechanisms are activated. The severity and prognosis after TBI vary widely, depending on factors such as the site of the injury, the patient's premorbid history, and the severity of the injury, and can result in long-term sequelae impacting multiple organs and systems, with a reduction in the life expectancy of these individuals.
View Article and Find Full Text PDFDiagnosis and Management of Mild Traumatic Brain Injury (mTBI): A Comprehensive, Patient-centered Approach.
Curr Pain Headache Rep
January 2025
Department of Rehabilitation Medicine, Jefferson Moss-Magee Rehabilitation Hospital, Philadelphia, PA, USA.
Purpose Of Review: The purpose of this review is to provide an update regarding recent research and recommendations in the care of mild traumatic brain injury (mTBI).
Recent Findings: New diagnostic criteria for mTBI have recently been developed by the American Congress of Rehabilitation Medicine through the Delphi method and this will help to standardize assessment, diagnosis, and treatment. Symptoms of mTBI are diverse and can sometimes become persistent.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!