North Texas Research Forum 2024
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Division
North Texas
Hospital
Medical City Plano
Specialty
General Surgery
Document Type
Poster
Publication Date
2024
Keywords
extracorporeal membrane oxygenation, ECMO, trauma
Disciplines
Medicine and Health Sciences | Surgery | Trauma
Abstract
INTRODUCTION: ECMO has been used for decades in patients where adequate oxygenation could not be achieved using traditional efforts. Despite its increasing use in the trauma setting, there is a lack of published data to support its use and safety. This review will seek to answer among trauma patients who receive ECMO what their common demographics, injuries, co-morbidities, outcomes and adverse events are. METHODS: This is a single-center retrospective chart review conducted at an Level 1 trauma center between 2020 and 2023. Designation as trauma and ECMO utilization were the inclusion criteria. Patients under age 18 and non-trauma ECMO patients were excluded. Study variables included patient demographics, MOI, number of days on ECMO, hospital LOS, type of ECMO, survival to decannulation, injuries, co-morbidities, survival to discharge, and adverse events on ECMO. RESULTS: All 20 included patients were placed on VV ECMO. 19 males and 1 female were included. The average age was 28.5 (18-70) years. BMI average was 34.3 (19.9-50.7). The mean days on ECMO were 9.1 (2-29) and mean inpatient LOS was 33.85 (3-76) days. 19/20 (95%) of patients survived to decannulation. Survival to discharge was 16/20 (80%). Mechanism of injury included 17/20 (85%) blunt, 2/20 (10%) penetrating, and 1/20 with 40%TBSA burns. Of the 20 patients reviewed, 7 (35%) suffered TBI. Of the patients with TBI, 4/7 (57%) survived to discharge. 3 of the 4 patients who did not survive until discharge had documented TBIs, but overall rate of survival with TBI was (57%). The most common injury noted was rib fractures with a mean of 4.6 (0-13) per patient. 10 patients (50%) had pneumothoraces and 7 (35%) hemothoraces. Blunt cardiac injury affected 4/20 (20%). The most common co-morbidity was hypertension, occurring in 6/20 (30%). 3/20 (15%) of patients had diabetes mellitus. The most common complication during ECMO was bleeding requiring transfusion, which occurred in 9/20 (45%) of patients. 3 patients (15%) developed DVT. Two patients (10%) developed DIC. One patient (5%) had limb ischemia. CONCLUSION: ECMO usage in the trauma setting is an important adjunct in care. This allows additional time for pulmonary recovery and may increase survival and improve overall outcomes. The outcomes from our limited study showed a higher survival rate (80%) compared to the current published outcomes (57%) of the Extracorporeal Life Support Organization (ELSO). Future research with increased sample size will be invaluable for the continued understanding of the role of ECMO in trauma.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Miller, April; Post, Megan; Pellachia, Crescens; and Bini, John, "Analysis of ECMO Usage in Trauma Patients at a Major Level 1 Trauma Center" (2024). North Texas Research Forum 2024. 45.
https://scholarlycommons.hcahealthcare.com/northtexas2024/45