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Resuscitation, Trauma, ECLS, ECMO

David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Adriano Peris, Giovanni Cianchi, Simona Biondi, Manuela Bonizzoli, Andrea Pasquini, Massimo Bonacchi, Marco Ciapetti, Giovanni Zagli, Simona Bacci, Chiara Lazzeri, Pasquale Bernardo, Erminia Mascitelli, Guido Sani, Gian Franco Gensini
INTRODUCTION: Extracorporeal Life Support (ECLS) and extracorporeal membrane oxygenation (ECMO) have been indicated as treatment for acute respiratory and/or cardiac failure. Here we describe our first year experience of in-hospital ECLS activity, the operative algorithm and the protocol for centralization of adult patients from district hospitals. METHODS: At a tertiary referral trauma center (Careggi Teaching Hospital, Florence, Italy), an ECLS program was developed from 2008 by the Emergency Department and Heart and Vessel Department ICUs...
2010: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
A J Michaels, R J Schriener, S Kolla, S S Awad, P B Rich, C Reickert, J Younger, R B Hirschl, R H Bartlett
OBJECTIVE: To present a series of 30 adult trauma patients who received extracorporeal life support (ECLS) for pulmonary failure and to retrospectively review variables related to their outcome. METHODS: In a Level I trauma center between 1989 and 1997, ECLS with continuous heparin anticoagulation was instituted in 30 injured patients older than 15 years. Indication was for an estimated mortality risk greater than 80%, defined by a PaO2: FIO2 ratio less than 100 on 100% FIO2, despite pressure-mode inverse ratio ventilation, optimal positive end-expiratory pressure, reasonable diuresis, transfusion, and prone positioning...
April 1999: Journal of Trauma
M J Perchinsky, W B Long, J G Hill, J A Parsons, J B Bennett
BACKGROUND: Patients who have massive but potentially survivable injuries frequently die from complications of hypovolemia, hypoxemia, hypothermia, metabolic acidosis, and coagulopathy. Emergency cardiopulmonary bypass has been unsuccessful in preventing such deaths because it involves systemic anticoagulation that exacerbates coagulopathy. PATIENTS AND METHODS: A simplified extracorporeal cardiopulmonary life support (ECLS) system was assembled consisting of a centrifugal pump head, heat exchanger, membranous oxygenator, percutaneous cannulas, and heparin-bonded circuitry...
May 1995: American Journal of Surgery
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