Document Detail

Prolonged heparin-free extracorporeal membrane oxygenation in multiple injured acute respiratory distress syndrome patients with traumatic brain injury.
MedLine Citation:
PMID:  22673280     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) can be used as an "ultima ratio" 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.
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.
RESULTS: : Using this strategy, neither ECMO-associated bleeding nor clotting of the extracorporeal circuit occurred. All patients survived.
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.
LEVEL OF EVIDENCE: IV, therapeutic study.
Ralf M Muellenbach; Markus Kredel; Ekkehard Kunze; Peter Kranke; Julian Kuestermann; Alexander Brack; Armin Gorski; Christian Wunder; Norbert Roewer; Thomas Wurmb
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  72     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-06-07     Completed Date:  2012-08-21     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1444-7     Citation Subset:  AIM; IM    
Department of Anaesthesia and Critical Care, University of Würzburg, Germany.
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MeSH Terms
Anticoagulants / contraindications
Brain Injuries / complications*,  therapy
Extracorporeal Membrane Oxygenation / methods*
Follow-Up Studies
Heparin / contraindications*
Middle Aged
Multiple Trauma / complications*,  therapy
Respiratory Distress Syndrome, Adult / etiology,  therapy*
Reg. No./Substance:
0/Anticoagulants; 9005-49-6/Heparin

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