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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2014 | Original research

Venoarterial extracorporeal life support in post-traumatic shock and cardiac arrest: lessons learned

Authors: Yuan-His Tseng, Tzu-I Wu, Yuan-Chang Liu, Pyng-Jing Lin, Meng-Yu Wu

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2014

Abstract

Objectives

Venoarterial extracorporeal life support (VA-ECLS) is an effective support of acute hemodynamic collapse caused by miscellaneous diseases. However, using VA-ECLS for post-traumatic shock is controversial and may induce a disastrous hemorrhage. To investigate the feasibility of using VA-ECLS to treat post-traumatic shock or cardiac arrest (CA), a single-center experience of VA-ECLS in traumatology was reported.

Materials and methods

This retrospective study included nine patients [median age: 37 years, interquartile range (IQR): 26.5-46] with post-traumatic shock/CA who were treated with VA-ECLS in a single institution between November 2003 and October 2012. The causes of trauma were high-voltage electrocution (n = 1), penetrating chest trauma (n = 1), and blunt chest or poly-trauma (n = 7). Medians of the injury severity score and the maximal chest abbreviated injury scale were 34 (IQR: 15.5-41) and 4 (IQR: 3-4), respectively. All patients received peripheral VA-ECLS without heparin infusion for at least 24 hours.

Results

The median time from arrival at our emergency department (ED) to VA-ECLS was 6 h (IQR: 4-47.5). The median duration of VA-ECLS was 91 h (IQR: 43-187) with a duration < 24 h in 2 patients. Among the 9 patients, 5 received VA-ECLS to treat the post-traumatic shock/CA presenting during (n = 2) or following (n = 3) damage-control surgeries for initial trauma, and another 4 patients were supported for non-surgical complications associated with initial trauma. VA-ECLS was terminated in 2 non-survivors owing to uncontrolled hemothorax or retroperitoneal hemorrhage. Three patients survived to hospital discharge. All of them received damage-control surgeries for initial trauma and experienced a complicated hospitalization after weaning off VA-ECLS.

Conclusion

Using VA-ECLS to treat post-traumatic shock/CA is challenging and requires multidisciplinary expertise.

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Title: Venoarterial extracorporeal life support in post-traumatic shock and cardiac arrest: lessons learned
Authors: Yuan-His Tseng
Tzu-I Wu
Yuan-Chang Liu
Pyng-Jing Lin
Meng-Yu Wu
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2014
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-22-12

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Venoarterial extracorporeal life support in post-traumatic shock and cardiac arrest: lessons learned

Abstract

Objectives

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

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