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World J Emerg Surg. 2015 Mar 12;10:15. doi: 10.1186/s13017-015-0006-9. eCollection 2015.

Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review.

Author information

1
General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Trauma Division, Surgery Department, Changhua Christian Hospital, 500 No. 135, Nanxiao Street, Changhua City, Taiwan ; Surgery Department, Cishan Hospital, 84247 No. 60, Zhongxue Rd., Cishan District, Kaohsiung City, Taiwan.
2
General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Trauma Division, Surgery Department, Changhua Christian Hospital, 500 No. 135, Nanxiao Street, Changhua City, Taiwan.
3
Cardiovascular Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan.
4
General Surgery Division, Surgery Department, Changhua Christian Hospital, Changhua City, Taiwan ; Transplant Medicine and Surgery Research Centre, Changhua Christian Hospital, Changhua City, Taiwan.
5
Transplant Medicine and Surgery Research Centre, Changhua Christian Hospital, Changhua City, Taiwan.

Abstract

Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonary contusion and other organ hemorrhage because of systemic anticoagulation during the treatment. We herein report a patient who successfully survive a multitrauma combining pulmonary contusion and grade IV liver laceration using non-heparinized venovenous extracorporeal membrane oxygenation (vv-ECMO). The associated literature were reviewed.

KEYWORDS:

Acute pulmonary contusion; ECMO; Heparin-free; Internal bleeding; Polytraumatic

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