Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Initial Experiences of Extracorporeal Membrane Oxygenation for Trauma Patients at a Single Regional Trauma Center in South Korea

  • Ko, Ji Wool (Department of Surgery, Yonsei University Wonju College of Medicine) ;
  • Park, Il Hwan (Department of Thoracic Surgery, Yonsei University Wonju College of Medicine) ;
  • Byun, Chun Sung (Department of Thoracic Surgery, Yonsei University Wonju College of Medicine) ;
  • Jang, Sung Woo (Department of Surgery, Yonsei University Wonju College of Medicine) ;
  • Jun, Pil Young (Department of Surgery, Yonsei University Wonju College of Medicine)
  • Received : 2020.11.24
  • Accepted : 2020.12.17
  • Published : 2021.09.30
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Abstract

Purpose: For severe lung injuries or acute respiratory distress syndrome that occurs during critical care due to trauma, extracorporeal membrane oxygenation (ECMO) may be used as a salvage treatment. This study aimed to describe the experiences at a single center with the use of ECMO in trauma patients. Methods: We enrolled a total of 25 trauma patients who were treated with ECMO between January 2015 and December 2019 at a regional trauma center. We analyzed and compared patients' characteristics between survivors and non-survivors through a medical chart review. We also compared the characteristics of patients between direct and indirect lung injury groups. Results: The mean age of the 25 patients was 45.9±19.5 years, and 19 patients (76.0%) were male. The mean Injury Severity Score was 26.1±10.1. Ten patients (40.0%) had an Abbreviated Injury Scale (AIS) 3 score of 4, and six patients (24.0%) had an AIS 3 score of 5. There were 19 cases (76.6%) of direct lung injury. The mortality rate was 60.0% (n=15). Sixteen patients (64.0%) received a loading dose of heparin for the initiation of ECMO. There was no significant difference in heparin use between the survivors and non-survivors (70% in survivors vs. 60% in non-survivors, p=0.691). When comparing the direct and indirect lung injury groups, there were no significant differences in variables other than age and ECMO onset time. Conclusions: If more evidence is gathered, risk factors and indications will be identified and we expect that more trauma patients will receive appropriate treatment with ECMO.

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