A Review of Burn Patients Requiring Extracorporeal Membrane Oxygenation at a Burns Facility

Abstract

Respiratory compromise is a recognised sequelae of major burn injuries, and in rare instances requires extracorporeal membrane oxygenation (ECMO). Over a ten-year period, our hospital trust, an ECMO centre and burns facility, had five major burn patients requiring ECMO, whose burn injuries would normally be managed at trusts with higher levels of burn care. Three patients (60%) survived to hospital discharge, one (20%) died at our trust, and one patient died after repatriation. All patients required regular, time-intensive dressing changes from our specialist nursing team, beyond their regular duties. This review presents these patients, as well as a review of the literature on the use of ECMO in burn injury patients. A formal review of the overlap between the networks that cater to ECMO and burn patients is recommended.

The Use of Extracorporeal Membrane Oxygenation for Burns: A Systematic Review and Meta-Analysis

“…15,16 Limited evidence for ECMO use in patients with burns, in addition to few suitable patients and lack of experience, were the most commonly reported barriers to more widespread utilization of ECMO in the care of patients with severe burns. 17 A systematic review in 2013 of 69 patients found that the pooled survival of patients with severe burns and inhalation injury receiving ECMO was 54%, 18 comparable with that reported by the Extracorporeal Life Support Organization (ELSO) registry for acute respiratory failure. 19 However, more recent reports have suggested that mortality can be as high as 72%.…”

“…Using it to manage patients with burns will require more specialized personnel and more man-hours than conventional therapies. 17 This study has several strengths. We used a comprehensive search strategy to effectively summarize the current literature of ECMO in burns.…”

“…Using it to manage patients with burns will require more specialized personnel and more man-hours than conventional therapies. 17…”