Advanced extracorporeal therapy in trauma

Zonies, D. & Merkel, M.Current Opinion in Critical Care22(6) pp. 578–583

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.

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