Arteriovenous Extracorporeal Lung Assist and High Frequency Oscillatory Ventilation in Post-Traumatic Acute Respiratory Distress Syndrome

Brederlau, Joerg; Anetseder, Martin; Schoefinius, Andreas; Wurmb, Thomas; Muellenbach, Ralf Michael; Kredel, Markus; Schwemmer, Ulrich; Zahn, P; Thiel, A.; Roewer, Norbert

doi:10.1097/01.ta.0000224919.19519.2e

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…neuromuscular blockade, iNO, prone ventilation, and HFOV), making salvage therapy comparisons for severe ARDS difficult to interpret. [2][3][4][5] Based on available data, overall survival for ECMO varies from 44% to 79% in trauma. 6,7 Compared to severe respiratory failure in the uninjured population, trauma ECMO survival rates may be higher than non-trauma ECMO survival rates.…”

Section: Discussionmentioning

confidence: 99%

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Extracorporeal membrane oxygenation in trauma: A single institution experience and review of the literature

et al. 2018

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Section: Discussionmentioning

confidence: 99%

“…neuromuscular blockade, iNO, prone ventilation, and HFOV), making salvage therapy comparisons for severe ARDS difficult to interpret. 2–5…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation in trauma: A single institution experience and review of the literature

et al. 2018

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“…genschäden nachweisen konnten, vor allem Fallberichte bei therapierefraktärem ARDS, bei denen die HFOV allein[5] oder in Kombination mit extrakorporaler CO 2 -Elimination[4,6,20] bzw. NO-Inhalation[17] erfolgreich eingesetzt werden konnte.…”

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Moderne Beatmungskonzepte in der Therapie des akuten Atemnotsyndroms (ARDS)

Ellis¹,

Burkhardt²,

Welte³

2008

Dtsch med Wochenschr

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In current intensive care medicine mechanical ventilation is of particular importance. In recent years new ventilation concepts have been established. Most notably, the idea of protective ventilation of patients suffering from ARDS had lasting effects in the ventilation management on these patients. In contrast to other ventilation concepts, a significant survival benefit was shown. Alternative treatment options are high-frequency-oscillatory ventilation, extracorporeal assist devices or a combination of both in order to apply an extrem small tidal volume. These alternative treatment options have never been evaluated in randomised controlled trials, so a definite statement for practical application cannot be made.

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“…Several case reports and small case series describe the use of ECLS in the management of pediatric and adult traumatic respiratory failure including blunt and penetrating parenchymal and tracheobronchial injuries [1][2][3][4][5][6][7][8][9][10], cardiac contusions [11][12][13], traumatic brain injury [14][15][16][17], and shock [18][19][20]. Retrospective cohort studies of trauma patients cared for at tertiary care referral centers report survival after ECLS ranging from 50-79% [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Extracorporeal Life Support in Trauma

2014

J Surg

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Background: Extracorporeal life support (ECLS) is a lifesaving treatment for critically ill trauma patients with refractory cardiopulmonary failure. The purpose of this analysis is to use a large national trauma database to characterize the use and outcomes of ECLS in trauma. Methods:Patients from centers that performed ECLS were identified from the 2007-2009 National Trauma Data Bank (NTDB). Demographic, clinical, and outcome data were abstracted. Univariate analyses were performed using chi-square, Mann-Whitney U-test, and regression analyses. Propensity score analysis and multiple regression models were developed using backwards stepwise logistic regression to identify risk factors for ECLS and predictors of mortality; p<0.05 was considered significant.Results: Forty-two centers of 682 (6%) performed ECLS on 78 of 245,950 patients (0.03%). ECLS patients were younger, more severely injured, had a longer ICU and hospital length of stay, and a higher mortality. Univariate analysis showed that ECLS patients had a significantly increased risk of death (OR 28; p<0.001). Among patients receiving ECLS, predictors of mortality included injury severity score (ISS) (OR 1.06; 95% CI 1.01-1.11; p=0.03) and cardiac arrest (OR 7.57; 95% CI 1.58-36.2; p=0.01). After propensity score adjusted logistic regression, ECLS was still a significant predictor of mortality (OR 6, 95% CI 2.76-13.1, p<0.01). Patients receiving ECLS at a center that performed 5 or more ECLS runs trended towards a lower mortality rate (27% vs. 73%, p=0.10). Conclusions:ECLS is infrequently used in the trauma setting. When compared to other trauma patients, ECLS patients are more critically ill and are at increased odds of death. Further study is required to determine which patient and hospital characteristics predict improved survival.

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Arteriovenous Extracorporeal Lung Assist and High Frequency Oscillatory Ventilation in Post-Traumatic Acute Respiratory Distress Syndrome

Cited by 6 publications

References 22 publications

Extracorporeal membrane oxygenation in trauma: A single institution experience and review of the literature

Extracorporeal membrane oxygenation in trauma: A single institution experience and review of the literature

Moderne Beatmungskonzepte in der Therapie des akuten Atemnotsyndroms (ARDS)

Outcomes of Extracorporeal Life Support in Trauma

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