Prolonged heparin-free extracorporeal membrane oxygenation in multiple injured acute respiratory distress syndrome patients with traumatic brain injury

作者：Muellenbach Ralf M^*; Kredel Markus; Kunze Ekkehard; Kranke Peter; Kuestermann Julian; Brack Alexander; Gorski Armin; Wunder Christian; Roewer Norbert; Wurmb Thomas

来源：Journal of Trauma and Acute Care Surgery, 2012, 72(5): 1444-1447.

DOI：10.1097/TA.0b013e31824d68e3

• Acute respiratory distress syndrome
• traumatic brain injury
• extracorporeal membrane oxygenation
• multiple trauma

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) can be used as an %26quot;ultima ratio%26quot; strategy in multiple injured patients with severe thoracic trauma. However, systemic anticoagulation during ECMO is recommended and thus traumatic brain injury (TBI) and intracranial bleeding are well-accepted contraindications for ECMO therapy. %26lt;br%26gt;METHODS: This report describes three cases of prolonged heparin-free venovenous ECMO in multiple injured acute respiratory distress syndrome patients with severe TBI failing conventional mechanical ventilation. %26lt;br%26gt;RESULTS: Using this strategy, neither ECMO-associated bleeding nor clotting of the extracorporeal circuit occurred. All patients survived. %26lt;br%26gt;CONCLUSIONS: Based on our experience, we recommend the use of heparin-free ECMO in multiple injured patients with pulmonary failure that is not successfully controlled by lung-protective ventilation even if severe TBI is present. (J Trauma. 2012;72: 1444-1447.

• 出版日期2012-5