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ECLS Trauma

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https://www.readbyqxmd.com/read/27904968/outcome-measures-of-extracorporeal-life-support-ecls-in-trauma-patients-versus-patients-without-trauma-a-7-year-single-center-retrospective-cohort-study
#1
Christopher Ull, Thomas A Schildhauer, Justus T Strauch, Justyna Swol
This single-center retrospective study included a total of 99 extracorporeal life support (ECLS) cannulated patients assigned to a traumatic extracorporeal life-support cohort (TECLS) or a non-traumatic extracorporeal life-support cohort (NTECLS). Forty-nine TECLS patients and 50 NTECLS patients were compared. The TECLS patients were significantly younger [49.9 years 16.6-86.2 vs. 57.1 (21.4-78.6); p = 0.007] and had lower body mass indices (BMIs) [27.7 kg/m(2) (20-37) vs. 32.5 (19-88.5); p = 0.001] than the NTECLS patients...
November 30, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#2
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27866648/extracorporeal-life-support-is-safe-in-trauma-patients
#3
Christopher R Burke, Angelena Crown, Titus Chan, D Michael McMullan
INTRODUCTION: The role of extracorporeal life support (ECLS) in the critically ill trauma patient is poorly defined, possibly leading to the underutilization of this lifesaving therapy in this population. This study examined survival rates and risk factors for death in trauma patients who received ECLS. METHODS: Data from the National Trauma Data Bank was retrospectively reviewed to identify trauma patients who received ECLS from January 2012 to December 2014. Clinical outcomes and risk factors for death were examined in these patients...
November 11, 2016: Injury
https://www.readbyqxmd.com/read/27811560/advanced-extracorporeal-therapy-in-trauma
#4
David Zonies, Matthias Merkel
PURPOSE OF REVIEW: The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described. RECENT FINDINGS: ECLS use is increasing among trauma patients. Several recent studies among trauma patients report survival rates of 65-79%. Despite the high bleeding risk, extracorporeal membrane oxygenation (ECMO) may be safely implemented in trauma patients based on a strict protocol-driven policy...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27779589/extracorporeal-life-support-in-trauma-worth-the-risks
#5
Kareem Bedeir, Raghu Seethala, Edward Kelly
BACKGROUND: Extracorporeal life support (ECLS) is a potentially life-saving procedure for trauma patients with severe respiratory failure. Despite this, only a limited number of publications report series of trauma patients who underwent ECLS. The performance and safety of this technology in trauma patients is not fully understood. We described the efficacy and complications of ECLS in trauma patients with respiratory failure. METHODS: A systematic review of published reports was performed utilizing the Medical Literature Analysis and Retrieval System Online (MEDLINE)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27283190/ecls-in-trauma-practical-application-and-a-review-of-current-status
#6
David Zonies
Extracorporeal life support has evolved considerably over the past two decades. Once considered as salvage or experimental therapy in adults, extracorporeal membrane oxygenation (ECMO) is evolving into a mainstream treatment for adult critical care. This is especially true in trauma and high-risk surgical patients, who have traditionally been excluded from consideration. Several technological advances have made this possible. This includes anticoagulant-bonded circuits, device miniaturization, servo-regulated centrifugal systems, and more efficient oxygenators...
June 9, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27122937/early-percutaneous-heparin-free-veno-venous-extra-corporeal-life-support-ecls-is-a-safe-and-effective-means-of-salvaging-hypoxemic-patients-with-complicated-chest-trauma
#7
Thay-Hsiung Chen, James Yao-Ming Shih, Joseph Juey-Ming Shih
BACKGROUND: The objective of this study was to assess the feasibility and safety of heparin-free veno-venous extracorporeal life support (VV ECLS) as a means of salvaging polytrauma patients with life-threatening hypoxemia. METHODS: This is a retrospective observational study on 7 consecutive trauma patients who underwent VV ECLS for severe chest trauma unresponsive to conventional measures. RESULTS: The median time to ECLS was within 10 hrs (IQR 2-53) of mechanical ventilation...
January 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/26989960/visual-outcomes-of-repeat-versus-primary-descemet-stripping-automated-endothelial-keratoplasty-a-paired-comparison
#8
Yoav Nahum, Michael Mimouni, Silvana Madi, Massimo Busin
PURPOSE: To compare the results of repeat Descemet stripping automated endothelial keratoplasty (DSAEK) with those of primary DSAEK. MATERIALS AND METHODS: This retrospective study consisted of all consecutive eyes that underwent one or more repeat DSAEK surgeries after primary DSAEK performed at Villa Serena-Villa Igea Private Hospitals (Forlì, Italy) between January 2005 and June 2015. A paired comparison between the outcomes of primary and the second DSAEK was performed...
May 2016: Cornea
https://www.readbyqxmd.com/read/26563488/extracorporeal-life-support-in-polytraumatized-patients
#9
Massimo Bonacchi
Major trauma is a leading cause of death, particularly amongst young patients. Conventional therapies for post-traumatic cardiovascular shock and acute pulmonary failure may sometimes be insufficient and even dangerous. New approaches to trauma care and novel salvage techniques are necessary to improve outcomes. Extracorporeal life support (ECLS) has proven to be effective in acute cardiopulmonary failure from different aetiologies, particularly when conventional therapies fail. Since 2008 we have used ECLS as a rescue therapy in severe poly-trauma patients with refractory clinical setting (cardiogenic shock, cardiac arrest, and/or pulmonary failure): the rationale for using ECLS in trauma patients is to support cardiopulmonary function, providing adequate systemic perfusion and, therefore, avoiding consequent multi-organ failure and permitting organ recovery...
November 10, 2015: International Journal of Surgery
https://www.readbyqxmd.com/read/26263439/low-dose-heparin-anticoagulation-during-extracorporeal-life-support-for-acute-respiratory-distress-syndrome-in-conscious-sheep
#10
Nicolas J Prat, Andrew D Meyer, Thomas Langer, Robbie K Montgomery, Bijaya K Parida, Andriy I Batchinsky, Andrew P Cap
BACKGROUND: Over 32% of burned battlefield causalities develop trauma-induced hypoxic respiratory failure, also known as acute respiratory distress syndrome (ARDS). Recently, 9 out of 10 US combat soldiers' survived life-threatening trauma-induced ARDS supported with extracorporeal membrane oxygenation (ECMO), a portable form of cardiopulmonary bypass. Unfortunately, the size, incidence of coagulation complications, and the need for systematic anticoagulation for traditional ECMO devices have prevented widespread use of this lifesaving technology...
December 2015: Shock
https://www.readbyqxmd.com/read/26189164/survival-and-quality-of-life-after-extracorporeal-life-support-for-refractory-cardiac-arrest-a-case-series
#11
Amedeo Anselmi, Erwan Flécher, Hervé Corbineau, Thierry Langanay, Vincent Le Bouquin, Marc Bedossa, Alain Leguerrier, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
OBJECTIVES: Extracorporeal life support (ECLS) is an emerging option to treat selected patients with cardiac arrest refractory to cardiopulmonary resuscitation (CPR). Our primary objective was to determine the mortality at 30 days and at hospital discharge among adult patients receiving veno-arterial ECLS for refractory cardiac arrest. Our secondary objectives were to determine the 1-year survival and the health-related quality of life, and to examine factors associated with 30-day mortality...
October 2015: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25855899/association-between-arterial-hyperoxia-and-outcome-in-subsets-of-critical-illness-a-systematic-review-meta-analysis-and-meta-regression-of-cohort-studies
#12
REVIEW
Hendrik J F Helmerhorst, Marie-José Roos-Blom, David J van Westerloo, Evert de Jonge
OBJECTIVE: Oxygen is vital during critical illness, but hyperoxia may harm patients. Our aim was to systematically evaluate the methodology and findings of cohort studies investigating the effects of hyperoxia in critically ill adults. DATA SOURCE: A meta-analysis and meta-regression analysis of cohort studies published between 2008 and 2015 was conducted. Electronic databases of MEDLINE, EMBASE, and Web of Science were systematically searched for the keywords hyperoxia and mortality or outcome...
July 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/25598094/enteral-nutrition-in-neonatal-and-pediatric-extracorporeal-life-support-a-survey-of-current-practice
#13
Thomas J Desmarais, Yan Yan, Martin S Keller, Adam M Vogel
PURPOSE: The purpose of this study was to characterize enteral (EN) nutrition practices in neonatal and pediatric patients receiving extracorporeal life support (ECLS). METHODS: A Web-based survey was administered to program directors and coordinators of Extracorporeal Life Support Organization centers providing neonatal and pediatric ECLS. The survey assessed patient and clinical factors relating to the administration of EN. RESULTS: A total of 122 responses (122/521, 23...
January 2015: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/25535176/inverted-takotsubo-cardiomyopathy-severe-refractory-heart-failure-in-poly-trauma-patients-saved-by-emergency-extracorporeal-life-support
#14
Massimo Bonacchi, Andrea Vannini, Guy Harmelin, Stefano Batacchi, Marco Bugetti, Guido Sani, Adriano Peris
OBJECTIVES: The sequelae of severe poly-trauma may include myocardial dysfunction followed by acute heart failure and death. Inverted-Takotsubo cardiomyopathy (ITC) is a variant of stress cardiomyopathy, characterized by a contractile abnormality with extensive left ventricular circumferential dyskinesia or akinesia with a hyperkinetic apex. We report our experience with refractory cardiogenic shock and/or cardiac arrest, treated with extracorporeal life support. METHODS: From June 2008 to December 2011, we treated 4 adult poly-trauma patients (3 men, 1 woman, mean age: 27...
March 2015: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/25314088/ards-in-pregnancy
#15
REVIEW
Alexander G Duarte
Acute respiratory distress syndrome (ARDS) is an uncommon condition in pregnant patients. The causes of ARDS are associated with obstetric causes such as amniotic fluid embolism, preeclampsia, septic abortion, and retained products of conception or nonobstetric causes that include sepsis, aspiration pneumonitis, influenza pneumonia, blood transfusions, and trauma. An essential component in management of ARDS involves good communication between the obstetrics team and critical care specialist and a fundamental understanding of mechanical ventilatory support...
December 2014: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25273618/venovenous-extracorporeal-life-support-for-posttraumatic-respiratory-distress-syndrome-in-adults-the-risk-of-major-hemorrhages
#16
Meng-Yu Wu, Pyng-Jing Lin, Yuan-His Tseng, Kuo-Chin Kao, Hsuan-Ling Hsiao, Chung-Chi Huang
BACKGROUND: The aim of this retrospective study is to investigate the therapeutic benefits and the bleeding risks of venovenous extracorporeal life support (VV-ECLS) when used for adult posttraumatic respiratory distress syndrome (posttraumatic ARDS). MATERIALS AND METHODS: Twenty adult trauma patients (median age: 38 years, median injury severity score: 35) treated with VV-ECLS in a level I trauma center between January 2004 and June 2013 were enrolled in this study...
2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/24971508/survival-after-avalanche-induced-cardiac-arrest
#17
Yvonnick Boué, Jean-François Payen, Julien Brun, Sébastien Thomas, Albrice Levrat, Marc Blancher, Guillaume Debaty, Pierre Bouzat
AIM: Criteria to prolong resuscitation after cardiac arrest (CA) induced by complete avalanche burial are critical since profound hypothermia could be involved. We sought parameters associated with survival in a cohort of victims of complete avalanche burial. METHODS: Retrospective observational study of patients suffering CA on-scene after avalanche burial in the Northern French Alps between 1994 and 2013. Criteria associated with survival at discharge from the intensive care unit (ICU) were collected on scene and upon admission to Level-1 trauma center...
September 2014: Resuscitation
https://www.readbyqxmd.com/read/24900925/the-abdomen-in-thoracoabdominal-cannot-be-ignored-abdominal-compartment-syndrome-complicating-extracorporeal-life-support
#18
Arthur J Lee, Bryan J Wells, Rosaleen Chun, Chad G Ball, Andrew W Kirkpatrick
Extracorporeal life support (ECLS) is an incredible life-saving measure that is being used ever more frequently in the care of the critically ill. Management of these patients requires extreme vigilance on the part of the care providers in recognizing and addressing the complications and challenges that may arise. We present a case of overt abdominal compartment syndrome (ACS) in a previously well young male on ECLS with a history of trauma, submersion, hypothermia, and no intra-abdominal injuries. The patient developed ACS soon after ECLS was initiated which resulted in drastically compromised flow rates...
2014: Case Reports in Critical Care
https://www.readbyqxmd.com/read/24829813/extracorporeal-life-support-in-a-severe-blunt-chest-trauma-with-cardiac-rupture
#19
Launey Yoann, Flecher Erwan, Nesseler Nicolas, Malledant Yannick, Seguin Philippe
This report presents a case of severe blunt chest trauma secondary to a horse riding accident with resultant free-wall rupture of the left ventricle in association with severe lung contusion. We describe the initial surgical and medical management of the cardiac rupture which was associated with a massive haemoptysis due to severe lung trauma. Extra corporeal membrane oxygenation (ECMO) support was initiated and allowed both the acute heart and lung failure to recover. We discuss the successful use and pitfalls of ECMO techniques which are sparsely described in such severe combined cardiac and thoracic trauma...
2013: Case Reports in Critical Care
https://www.readbyqxmd.com/read/24747460/venovenous-extracorporeal-life-support-improves-survival-in-adult-trauma-patients-with-acute-hypoxemic-respiratory-failure-a-multicenter-retrospective-cohort-study
#20
MULTICENTER STUDY
Derek M Guirand, Obi T Okoye, Benjamin S Schmidt, Nicky J Mansfield, James K Aden, R Shayn Martin, Ramon F Cestero, Michael H Hines, Thomas Pranikoff, Kenji Inaba, Jeremy W Cannon
BACKGROUND: Venovenous extracorporeal life support (VV ECLS) has been reported in adult trauma patients with severe respiratory failure; however, ECLS is not available in many trauma centers, few trauma surgeons have experience initiating ECLS and managing ECLS patients, and there is currently little evidence supporting its use in severely injured patients. This study seeks to determine if VV ECLS improves survival in such patients. METHODS: Data from two American College of Surgeons-verified Level 1 trauma centers, which maintain detailed records of patients with acute hypoxemic respiratory failure (AHRF), were evaluated retrospectively...
May 2014: Journal of Trauma and Acute Care Surgery
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