J Korean Soc Traumatol.  2014 Dec;27(4):229-232. 10.0000/jti.2014.27.4.229.

Successful Use of Extracorporeal Membrane Oxygenation for Severe Lung Contusion and Stress-induced Cardiomyopathy Caused by Multiple Trauma

• Lee DS
• Gil EM
• Lee AL
• Ha TS
• Chung CR
• Park CM
• Cho YH

• KMID: 2297780
• DOI: http://doi.org/10.0000/jti.2014.27.4.229

Abstract

A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient's gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure.

Keyword

Extracorporeal membrane oxygenation; Multiple trauma; ARDS; Cardiomyopathy

MeSH Terms

Anoxia
Cardiomyopathies*
Cerebral Hemorrhage
Contusions*
Decision Making
Extracorporeal Membrane Oxygenation*
Heart
Hemopneumothorax
Hemorrhage
Hospitalization
Humans
Hypotension
Critical Care
Lung*
Multiple Trauma*
Oxygen
Rehabilitation
Rib Fractures
Skull Fractures
Ventilators, Mechanical
Oxygen