• Meng-Yu Wu, Pyng-Jing Lin, Yuan-His Tseng, Kuo-Chin Kao, Hsuan-Ling Hsiao, and Chung-Chi Huang.
• Department of Thoracic Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan 333, Taiwan. david3627@gmail.com.
• Scand J Trauma Resus. 2014 Oct 2; 22: 56.

BackgroundThe 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 MethodsTwenty 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. The indication of VV-ECLS for posttraumatic ARDS was refractory hypoxemia (PaO2/FiO2 ratio ≤ 70 mmHg) under advanced mechanical ventilation. To minimize potential complications, a protocol-guided VV-ECLS was adopted.ResultsSixteen patients were weaned off VV-ECLS, and of these patients fourteen survived. Medians of the trauma-to-ECLS time, the pre-ECLS mechanical ventilation, and the ECLS duration in all patients were 64, 45, and 144 hours respectively. The median PaO2/FiO2 ratio was improved significantly soon after VV-ECLS, from 56 to 106 mmHg (p < 0.001). However, seven major hemorrhages occurred during VV-ECLS, of which three were lethal. The multivariate analysis revealed that the occurrence of major hemorrhages during VV-ECLS was independently related to the trauma-to-ECLS time < 24 hours (OR: 20; p = 0.02; 95% CI: 2-239; c-index: 0.81).ConclusionsDespite an effective respiratory support, VV-ECLS should be cautiously administered to patients who develop advanced ARDS soon after major trauma.

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