Journal Article

Craniotomy during ECMO in a severely traumatized patient

Lirk, P., Mayr, A. J., Peer, R., Hasibeder, W. R., Rieder, J., Knotzer, H., Friesenecker, B. E., Dünser, M. W.

2005

Overview

Extracorporeal membrane oxygenation (ECMO) can be a last resort treatment in acute respiratory distress syndrome after thoracic trauma. However, co-existent brain trauma is considered to be a contra-indication for ECMO. This is the first report on successful craniotomy under ECMO treatment in a multiply traumatized patient with severe thoracic and brain injuries. This successful treatment with beneficial neurological outcome suggests that ECMO therapy should not be withheld from severely injured patients with combined brain and thoracic trauma presenting with life-threatening hypoxemia. Moreover, even craniotomy may be performed during ECMO therapy without major bleeding and adverse effects on neurological function.

• Publisher: Springer Nature B.V
• Subject: Accidental Falls / Adult / Anticoagulants - adverse effects / Anticoagulants - standards / Brain - blood supply / Brain - diagnostic imaging / Brain - pathology / Brain Injuries - pathology / Brain Injuries - physiopathology / Brain Injuries - surgery / Cerebral Hemorrhage, Traumatic - etiology / Cerebral Hemorrhage, Traumatic - physiopathology / Cerebral Hemorrhage, Traumatic - surgery / Craniotomy - standards / Extracorporeal Membrane Oxygenation / Humans / Intracranial Hypertension - etiology / Intracranial Hypertension - physiopathology / Intracranial Hypertension - surgery / Lung - pathology / Lung - physiopathology / Lung Injury / Male / Respiratory distress syndrome / Respiratory Distress Syndrome, Adult - etiology / Respiratory Distress Syndrome, Adult - physiopathology / Respiratory Distress Syndrome, Adult - therapy / Respiratory therapy / Thoracic Injuries - complications / Thoracic Injuries - pathology / Thoracic Injuries - physiopathology / Tomography, X-Ray Computed