Indian Journal of Critical Care Case Report

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VOLUME 1 , ISSUE 3 ( November-December, 2022 ) > List of Articles


Veno-venous Extracorporeal Membrane Oxygenation in Severe Blunt Thoracic Trauma: A Case Report from India

Vijayant Solanki, Amit Mehta, Shailesh Jhawar

Keywords : Acute respiratory distress syndrome, Extracorporeal membrane oxygenation, Pneumothorax, Veno-venous extracorporeal membrane oxygenation

Citation Information : Solanki V, Mehta A, Jhawar S. Veno-venous Extracorporeal Membrane Oxygenation in Severe Blunt Thoracic Trauma: A Case Report from India. 2022; 1 (3):79-81.

DOI: 10.5005/jp-journals-11006-0032

License: CC BY-NC 4.0

Published Online: 02-01-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: In recent studies, veno-venous extracorporeal membrane oxygenation (VV ECMO) has been used to salvage blunt thoracic trauma patients with severe acute respiratory distress syndrome (ARDS), by providing required oxygenation in precarious scenarios. No such cases were found to be reported from Indian hospitals, and hence, we submit the following case. Case: A 30-year-old gentleman suffered blunt thoracic trauma. He presented with left side flail chest, with extensive bilateral contusions, and bilateral hemopneumothorax with extensive surgical emphysema. Initially, the patient was managed on invasive mechanical ventilation as per ARDS net protocol. However, the patient's oxygenation did not improve and he was required to be put on VV ECMO as per extracorporeal life support indications. Thereafter, he was weaned from VV ECMO on day 5 and later on, from mechanical ventilation. He was discharged from the hospital on day 30. Conclusion: Veno-venous extracorporeal membrane oxygenation (VV ECMO) is safe to use in severe ARDS patients who are not responding to oxygenation on mechanical ventilation.

  1. Kumar S, Gupta HO, Pandey A, et al. Thoracic trauma trends in Northern India-single center experience. Indian J Thoracic Cardiovasc Surg 2013;29:167–170. DOI: 10.1007/s12055-013-0231-3
  2. Dogrul BN, Kiliccalan I, Asci ES, et al. Blunt trauma related chest wall and pulmonary injuries: an overview. Chin J Traumatol 2020;23(3):125–138. DOI: 10.1016/j.cjtee.2020.04.003
  3. Haider T, Halat G, Heinz T, et al. Thoracic trauma and acute respiratory distress syndrome in polytraumatized patients: a retrospective analysis. Minerva Anestesiol 2017;83(10):1026–1033. DOI: 10.23736/s0375-9393.17.11728-1
  4. Combes A, Peek GJ, Hajage D, et al. ECMO for severe ARDS: systematic review and individual patient data meta-analysis. Intensive Care Med 2020;46(11):2048–2057. DOI: 10.1007/s00134-020-06248-3
  5. Wang C, Zhang L, Qin T, et al. Extracorporeal membrane oxygenation in trauma patients: a systematic review. World J Emerg Surg 2020;15(1):51. DOI: 10.1186/s13017-020-00331-2
  6. Martínez Casas I, Amador Marchante MA, Paduraru M, et al. Thorax trauma severity score: is it reliable for patient's evaluation in a secondary level hospital? Bull Emerg Trauma 2016;4(3):150–155. PMID: 27540549.
  7. Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009;374(9698):1351–1363. DOI: 10.1016/s0140-6736(09)61069-2
  8. Schmidt M, Bailey M, Sheldrake J, et al. Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure. The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score. Am J Respir Crit Care Med 2014;189(11):1374–1382. DOI: 10.1164/rccm.201311-2023oc
  9. Brogan T. Extracorporeal Life Support: the ELSO Red Book. 5th ed. ELSO; 2017.
  10. Vasques F, Romitti F, Gattinoni L, et al. How I wean patients from veno-venous extra-corporeal membrane oxygenation. Crit Care 2019;23(1):316. DOI: 10.1186/s13054-019-2592-5
  11. Bastos R, Calhoon JH, Baisden CE. Flail chest and pulmonary contusion. Semin Thorac Cardiovasc Surg 2008;20(1):39–45. DOI: 10.1053/j.semtcvs.2008.01.004
  12. Bardenheuer M, Obertacke U, Waydhas C, et al. Epidemiology of the severely injured patient. A prospective assessment of preclinical and clinical management. AG Polytrauma of DGU. Unfallchirurg 2000;103(5):355–363. DOI: 10.1007/s001130050550
  13. Bedeir K, Seethala R, Kelly E. Extracorporeal life support in trauma: worth the risks? A systematic review of published series. J Trauma Acute Care Surg 2017;82(2):400–406. DOI: 10.1097/TA.0000000000001292
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