ECMO in trauma care: What you need to know

Area of Science:

• Critical Care Medicine
• Trauma Surgery
• Cardiopulmonary Support

Background:

• Extracorporeal membrane oxygenation (ECMO) use in trauma patients has risen significantly over the last decade.
• Applications span adult, pediatric, and combat casualty populations, primarily for acute hypoxemic respiratory failure.
• Venovenous (VV ECMO) configuration is common for severe lung injury or post-pneumonectomy support.

Approach:

• This narrative review synthesizes current knowledge on ECMO in trauma.
• It details common indications, technical aspects of cannulation and management, and patient outcomes.
• The review also addresses and debunks common myths surrounding ECMO in this patient cohort.

Key Points:

• VV ECMO is indicated for acute hypoxemic respiratory failure in trauma patients with insufficient respiratory reserve.
• Early consultation and regional referral are crucial for optimal ECMO utilization in critically injured patients.
• Understanding technical aspects of ECMO cannulation and management is vital for successful patient outcomes.

Conclusions:

• ECMO offers a vital support modality for select critically injured trauma patients with respiratory compromise.
• Evidence-based management and early intervention can improve outcomes for trauma patients on ECMO.
• Further research is needed to refine ECMO protocols and address existing myths in trauma care.