Traumacast ECMO in the Trauma Patient
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Oct 29, 2024 Phil Mason, a CT and Transplant ICU Medical Director and ECMO expert, teams up with Brandon Parker, an Assistant Professor of Surgery and Medical Director of the Trauma ECMO Program, to dive deep into the world of ECMO for trauma patients. They discuss the nuances between VV and VA ECMO, highlighting key clinical trials like CESAR and EOLIA. The conversation explores patient selection, the importance of timely intervention, and the challenges of managing complex cases. They also speculate on future innovations in ECMO technology that could enhance patient outcomes.
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VV ECMO as Lung Dialysis
- Venovenous (VV) ECMO primarily supports respiratory failure by acting as a "dialysis" for the lungs.
- It can indirectly improve hemodynamics by reversing hypoxia, correcting acidosis, and allowing reduced ventilatory pressures.
VA ECMO’s Distinct Role and Risks
- Venoarterial (VA) ECMO supports both cardiac and respiratory functions by returning blood through an artery.
- It has risks like differential hypoxemia, limb ischemia, and left ventricular afterload increase, limiting its trauma use.
VV ECMO Stabilizes Bronchial Injury
- A trauma patient with bronchial injury and airway hemorrhage was stabilized on VV ECMO without systemic heparin.
- ECMO enabled delayed surgery and successful recovery despite continuous airway bleeding.