Extracorporeal membrane oxygenation in trauma patient in France: A retrospective nationwide registry
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Indications for Veno-venous (VV) or veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) after trauma rely on poor evidence. The main aims were to describe the population of trauma patients requiring either VV or VA ECMO and report their clinical management and outcomes. METHODS: An observational multicentre retrospective study was conducted in 17 Level 1 trauma centres in France between January 2010 and December 2021. All patients admitted for major trauma were screened for inclusion, and those receiving either VV ECMO or VA ECMO were included. The primary outcome was in-hospital mortality. RESULTS: Among the 52,851 patients screened, 179 were included, with 143 supported by VV ECMO (median [Q1-Q3] age 32 years [24-48]; men 83.5%; injury severity score [ISS] 33 [25-43] and 76 (53.6%) with a traumatic brain injury [TBI]) and 36 supported by VA ECMO (median age 39 years [25-55]; men 88.9%; ISS 36 [25-56] and 23 (63.9%) with a TBI). In the VV ECMO group, three indications for ECMO implementation were chest injuries (n = 68, 47.6%), ventilator-associated pneumonia (VAP; n = 57, 39.9%), and extra-respiratory acute respiratory distress syndrome (ARDS; n = 57, 39.9%). In the VV ECMO group, 45.8% (n = 65) died in the hospital, with 33 (48.5%) deaths following cannulation for chest injuries, 22 (39.3%) following cannulation for VAP, and 10 (55.6%) following cannulation for extrapulmonary ARDS. In the VA ECMO group, 75.0% (n = 27) died during their hospital stay. CONCLUSIONS: In-hospital mortality of trauma patients requiring ECMO for refractory ARDS varied according to indications. The best prognosis was observed in the subgroup of pneumonia-induced ARDS patients.
Authors: Vincent Legros, Yannick Hourmant, Louis Genty, Karim Asehnoune, Quentin De Roux, Lucie Picard, Jean-Denis Moyer, Fanny Bounes, Martin Cailloce, Anais Adolle, Alexandre Behouche, Benjamin Bergis, Jeremy Bourenne, Cyril Cadoz, Emilie Charbit, Jonathan Charbit, Baptiste Compagnon, Charlotte Florin, Nouchan Mellati, Marie Moisan, Helene Nougue, Fanny Planquart, Matthieu Pissot, Julien Pottecher, Guillaume Savary, Hadrien Winiszewski, Nicolas Mongardon, Mathieu Raux, Arthur James
Institutions: Centre Hospitalier Universitaire de Reims, Vieillissement, Fragilité, Université de Reims Champagne-Ardenne, Centre Hospitalier Universitaire de Nantes, Nantes Université, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Groupe de recherche clinique en anesthésie réanimation médecine périopératoire, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Centre Hospitalier Universitaire de Caen Normandie, Centre Hospitalier Universitaire de Toulouse, Centre Hospitalier Universitaire de Tours, Centre Hospitalier Universitaire de Grenoble, Bicêtre Hospital, Assistance Publique Hôpitaux de Marseille, Hôpital Beaujon, Centre Hospitalier Universitaire de Montpellier, Centre Hospitalier Universitaire de Bordeaux, Hôpital Européen Georges-Pompidou, Hôpitaux Universitaires de Strasbourg, Hôpital d'instruction des Armées Percy, Centre Hospitalier Universitaire de Besançon, Inserm, Neurophysiologie respiratoire expérimentale et clinique
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: hybrid
Estimated APC paid: $2,020
OpenAlex ID: W4405631791