Heparin-free veno-venous extracorporeal membrane oxygenation in a multiple trauma patient: A case report
- 주제(키워드) acute respiratory failure , extracorporeal membrane oxygenation , heparin , trauma
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Youn Young; Joo, Hyunyoung] Ewha Womans Univ Hosp, Dept Anesthesiol & Pain Med, Seoul, South Korea; [Baik, Hee Jung; Lee, Heeseung; Kim, Chi Hyo; Chung, Rack Kyung; Han, Jong In; Woo, Jae Hee] Ewha Womans Univ, Dept Anesthesiol & Pain Med, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000169202
- 본문언어 영어
- Published As https://dx.doi.org/10.1097/MD.0000000000019070
- PubMed https://pubmed.ncbi.nlm.nih.gov/32000456
초록/요약
Rationale:Extracorporeal membrane oxygenation (ECMO) in multiple trauma patients with post-traumatic respiratory failure can be quite challenging because of the need for systemic anticoagulation, which may lead to excessive bleeding. In the last decade, there is a growing body of evidence that veno-venous ECMO (VV-ECMO) is lifesaving in multiple trauma patients with acute respiratory distress syndrome, thanks to technical improvements in ECMO devices.Patient concerns:We report a case of a 17-year-old multiple trauma patient who was drunken and had confused mentality.Diagnoses:She was suffered from critical respiratory failure (life-threatening hypoxemia and severe hypercapnia/acidosis lasting for 70minutes) accompanied by cardiac arrest and trauma-induced coagulopathy during general anesthesia.Interventions:We decided to start heparin-free VV-ECMO after cardiac arrest considering risk of hemorrhage.Outcomes:She survived with no neurologic sequelae after immediate treatment with heparin-free VV-ECMO.Lessons:Heparin-free VV-ECMO can be used as a resuscitative therapy in multiple trauma patients with critical respiratory failure accompanied by coagulopathy. Even in cases in which life-threatening hypoxemia and severe hypercapnia/acidosis last for >1hours during CPR for cardiac arrest, VV-ECMO could be considered a potential lifesaving treatment.
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