Messing Jonathan A, Agnihothri Ritesh V, Van Dusen Rachel, Najam Farzad, Dunne James R, Honig Jacqueline R, Sarani Babak
From the *Department of Trauma and Acute Care Surgery, George Washington University Hospital, Washington, District of Columbia; †George Washington University School of Medicine, Washington, District of Columbia; ‡Department of Surgery Resident, George Washington University, Washington, District of Columbia; §Department of Cardiothoracic Surgery, George Washington University Hospital, Washington, District of Columbia; and ¶Cardiothoracic Intensive Care Unit, George Washington University Hospital, Washington, District of Columbia.
ASAIO J. 2014 Sep-Oct;60(5):597-9. doi: 10.1097/MAT.0000000000000103.
A 21-year-old male trauma patient presented after a motor vehicle crash, witnessed massive aspiration and sustained traumatic brain injury. On postinjury day 3, the patient progressed to adult respiratory distress syndrome (ARDS) refractory to all conventional therapies, prompting the use of extracorporeal membrane oxygenation (ECMO). After 5 days of ECMO support and 3 thrombosed oxygenators, systemic anticoagulation was initiated. After 20 days of ECMO, 15 of which required systemic anticoagulation, the patient was decannulated and transferred to a rehabilitation facility. The patient is currently home without any neurological deficits. Although controversial, ECMO may serve a role as a rescue therapy in ARDS when conventional therapies fail in the brain-injured patient.
一名21岁男性创伤患者在机动车碰撞事故后就诊，发生大量误吸并遭受创伤性脑损伤。受伤后第3天，患者进展为对所有传统治疗均无效的成人呼吸窘迫综合征（ARDS），因此启用体外膜肺氧合（ECMO）。在接受5天的ECMO支持且3个氧合器出现血栓形成后，开始进行全身抗凝。在接受20天的ECMO治疗（其中15天需要全身抗凝）后，患者拔除插管并转至康复机构。该患者目前已回家，无任何神经功能缺损。尽管存在争议，但当传统治疗对脑损伤患者无效时，ECMO可作为ARDS的一种挽救治疗手段。
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