Successful implementation of prophylactic veno-venoarterial extracorporeal membrane oxygenation in high-risk trauma surgery: A case report

Perfusion. 2023 Dec 5:2676591231220832. doi: 10.1177/02676591231220832. Online ahead of print.

Abstract

Introduction: Extracorporeal Membrane Oxygenation (ECMO) is increasingly utilized in trauma care, yet its elective use during high-risk surgeries remains unreported.

Case report: We report a successful instance of prophylactic ECMO support via a Veno-Venoarterial (V-VA) configuration during high-risk surgery in a patient with extensive trauma, including severe thoracic damage and a highly unstable thoracic spine fracture. V-VA ECMO prevented complications such as hemodynamic and respiratory collapse associated with chest compression during the surgical procedure, as the patient should be in a prone position.

Discussion: The potential of ECMO as prophylactic support in high-risk surgery amongst trauma patients underscores a novel application of this technology. Complex configurations must be evaluated to avoid associated ECMO complications.

Conclusion: Our case highlights the potential of prophylactic ECMO hybrid modes, indicating their safe application during high-risk procedures in select trauma patients.

Keywords: elective extracorporeal membrane oxygenation; extracorporeal membrane oxygenation; extracorporeal membrane oxygenation trauma; hybrid mode; prophylactic extracorporeal membrane oxygenation; trauma; venous-venoarterial.