Extracorporeal Circulatory Systems and Their Role in Military Medicine: A Clinical Review

Abstract

This study was undertaken to clinically review the historical use, current manufacturing trends, and military application of extracorporeal circulatory (ECC) systems to treat pulmonary trauma patients. In the past 50 years, ECC support has evolved into a viable treatment option for pulmonary patients. New developments in ECC systems, such as heparin-bonded circuit designs like the Lifebridge B2T and the Novalung, are giving providers more choices with which to initiate ECC support and transport those injured while supporting the global war on terrorism. If ECC support is adopted by the military, then a training program that includes a review of standard operating procedures, equipment types, pharmaceutical dosing, transport with ground and air assets, and the effects of temperature and elevation changes on the circuits should be instituted. Reviewing all possible treatment choices for pulmonary insults received during this war should give providers additional tools with which to save lives.

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

“…Consequently, it became much easier to deliver ECMO-based therapies, in the setting of acute, refractory respiratory failure, for extended periods of time [17]. Prolonged cardiopulmonary support based on ECMO is now considered a viable option in risk-appropriate, carefully selected non-cardiac surgery patients [18,19]. At the same time, other non-interventional treatment options and adjuncts are being refined and potential new indications proposed which are actively and dynamically changing the landscape of clinical utilization of ECMO [20][21][22][23][24][25].…”

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

“…Consequently, it became much easier to deliver ECMO-based therapies, in the setting of acute, refractory respiratory failure, for extended periods of time [17]. Prolonged cardiopulmonary support based on ECMO is now considered a viable option in risk-appropriate, carefully selected non-cardiac surgery patients [18,19]. At the same time, other non-interventional treatment options and adjuncts are being refined and potential new indications proposed which are actively and dynamically changing the landscape of clinical utilization of ECMO [20][21][22][23][24][25].…”

Anaesthetic and Critical Care Management of Thoracic Injuries

“…This often limits the ability to apply strict low volume, low pressure strategies. One technique that has shown promise in military casualties is extracorporeal carbon dioxide removal [42]. These devices use heparin bonded circuits, negating the need for anticoagulation, and arterio-venous cannulation, rather than needing a pump.…”

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

“…Consequently, it became much easier to deliver ECMO-based therapies, in the setting of acute, refractory respiratory failure, for extended periods of time [17]. Prolonged cardiopulmonary support based on ECMO is now considered a viable option in risk-appropriate, carefully selected non-cardiac surgery patients [18,19]. At the same time, other non-interventional treatment options and adjuncts are being refined and potential new indications proposed which are actively and dynamically changing the landscape of clinical utilization of ECMO [20][21][22][23][24][25].…”

Anaesthetic and Critical Care Management of Thoracic Injuries

“…This often limits the ability to apply strict low volume, low pressure strategies. One technique that has shown promise in military casualties is extracorporeal carbon dioxide removal [42]. These devices use heparin bonded circuits, negating the need for anticoagulation, and arterio-venous cannulation, rather than needing a pump.…”

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

“…Consequently, it became much easier to deliver ECMO-based therapies, in the setting of acute, refractory respiratory failure, for extended periods of time [17]. Prolonged cardiopulmonary support based on ECMO is now considered a viable option in risk-appropriate, carefully selected non-cardiac surgery patients [18,19]. At the same time, other non-interventional treatment options and adjuncts are being refined and potential new indications proposed which are actively and dynamically changing the landscape of clinical utilization of ECMO [20][21][22][23][24][25].…”

Anaesthetic and Critical Care Management of Thoracic Injuries

“…This often limits the ability to apply strict low volume, low pressure strategies. One technique that has shown promise in military casualties is extracorporeal carbon dioxide removal [42]. These devices use heparin bonded circuits, negating the need for anticoagulation, and arterio-venous cannulation, rather than needing a pump.…”