Skip to main content

Advertisement

SpringerLink
Log in

Veno-arterial-venous extracorporal membrane oxygenation (V-AV ECMO) in a patient in ARDS and cardiac instability after severe polytrauma

  • Case Report
  • Artificial Lung / ECMO
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

The role of extracorporeal life support (ECLS) in critically ill trauma patients is underutilized, mainly due to concerns of anticoagulation. However, short-term ECLS in these patients can be safely performed with no or minimal systemic anticoagulation. Case series show favorable outcomes in trauma patients with veno-venous (V-V) and veno-arterial (V-A) ECMO, respectively, but there are only a few case reports of successful veno-arterio-venous (V-AV) ECMO in polytrauma patients. We report on a 63-year-old female admitted to our emergency department following a severe car accident who was successfully treated in a multidisciplinary approach, including bridging to damage control surgery and recovery with a V-AV ECMO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Amos T, Bannon-Murphy H, Yeung M, Gooi J, Marasco S, Udy A, Fitzgerald M. ECMO (extra corporeal membrane oxygenation) in major trauma: a 10 years single centre experience. Injury. 2021;52:2515–21. https://doi.org/10.1016/j.injury.2021.03.058. (Epub 2021 Apr 2 PMID: 33832706).

    Article  PubMed  Google Scholar 

  2. Bassi E, Azevedo LC, Costa EL, Maciel AT, Vasconcelos E, Ferreira CB, Malbouisson LM, Park M. Hemodynamic and respiratory support using venoarterial extracorporeal membrane oxygenation (ECMO) in a polytrauma patient. Rev Bras Ter Intensiva. 2011;23:374–9 (English, Portuguese PMID: 23949411).

    Article  PubMed  Google Scholar 

  3. Burke CR, Crown A, Chan T, McMullan DM. Extracorporeal life support is safe in trauma patients. Injury. 2017;48:121–6. https://doi.org/10.1016/j.injury.2016.11.008. (Epub 2016 Nov 11 PMID: 27866648).

    Article  PubMed  Google Scholar 

  4. Cordell-Smith JA, Roberts N, Peek GJ, Firmin RK. Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO). Injury. 2006;37:29–32. https://doi.org/10.1016/j.injury.2005.03.027. (Epub 2005 Oct 21 PMID: 16243331).

    Article  CAS  PubMed  Google Scholar 

  5. Fina D, Matteucci M, Jiritano F, Meani P, Kowalewski M, Ballotta A, Ranucci M, Lorusso R. Extracorporeal membrane oxygenation without systemic anticoagulation: a case-series in challenging conditions. J Thorac Dis. 2020;12:2113–9. https://doi.org/10.21037/jtd.2020.04.54. (PMID:32642115; PMCID:PMC7330289).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Krueger K, Schmutz A, Zieger B, Venovenous KJ. Extracorporeal membrane oxygenation with prophylactic subcutaneous anticoagulation only: an observational study in more than 60 patients. Artif Organs. 2017;41:186–92. https://doi.org/10.1111/aor.12737. (Epub 2016 Jun 3 PMID: 27256966).

    Article  CAS  PubMed  Google Scholar 

  7. Lang NW, Schwihla I, Weihs V, Kasparek M, Joestl J, Hajdu S, Sarahrudi K. Survival rate and outcome of extracorporeal life support (ECLS) for treatment of acute cardiorespiratory failure in trauma patients. Sci Rep. 2019;9:12902. https://doi.org/10.1038/s41598-019-49346-z. (PMID:31501453;PMCID:PMC6733857).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lee YY, Baik HJ, Lee H, Kim CH, Chung RK, Han JI, Joo H, Woo JH. Heparin-free veno-venous extracorporeal membrane oxygenation in a multiple trauma patient: a case report. Medicine (Baltimore). 2020;99:e19070. https://doi.org/10.1097/MD.0000000000019070. (PMID: 32000456; PMCID: PMC7004685).

    Article  PubMed  Google Scholar 

  9. Moon SH, Kim KN, Jung JJ, Park JH, Byun JH. Heparin-free veno-venous ECMO applied to a patient with severe lung contusion and hypovolemic shock due to trauma. Ulus Travma Acil Cerrahi Derg. 2018;24:497–500. https://doi.org/10.5505/tjtes.2018.33802. (PMID: 30394486).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine Intensive Care, Klinikum Stuttgart, Kriegsbergstr. 60, 70174, Stuttgart, Germany

    Johannes Heymer & Daniel Raepple

  2. Department of Anesthesiology and Intensive Care, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany

    Benjamin Fohr

Authors
  1. Johannes Heymer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Benjamin Fohr
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Raepple
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel Raepple.

Ethics declarations

Conflict of interest

The authors declare that there are no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heymer, J., Fohr, B. & Raepple, D. Veno-arterial-venous extracorporal membrane oxygenation (V-AV ECMO) in a patient in ARDS and cardiac instability after severe polytrauma. J Artif Organs 27, 163–166 (2024). https://doi.org/10.1007/s10047-023-01393-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-023-01393-0

Keywords

Search

Navigation