Pot Louis, Porto Alizée, Le Saux Audrey, Bichon Amandine, Cauchois Emi, Gainnier Marc, Carvelli Julien, Bourenne Jeremy
Réanimation des Urgences, Timone University Hospital APHM, 13005 Marseille, France.
Cardiac Surgery Department, Timone University Hospital APHM, 13005 Marseille, France.
Case Rep Crit Care. 2022 Jul 20;2022:1070830. doi: 10.1155/2022/1070830. eCollection 2022.
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is an adjuvant treatment for severe acute respiratory distress syndrome (ARDS) with refractory hypoxemia. Contraindications to therapeutic anticoagulation must be ruled out prior to ECMO implementation. We report the case of a 17-year-old male admitted in intensive care unit (ICU) for penetrating chest trauma due to multiple gunshot wounds. The body computed tomography (body CT scan) documented right pulmonary contusions and a homolateral hemothorax. His condition rapidly deteriorated with refractory hypoxemia due to lung contusion requiring invasive mechanical ventilation (IMV) and polytransfused hemorrhagic shock. During his stay in ICU, venovenous ECMO (VV-ECMO) was implemented twice, firstly for trauma-induced ARDS and secondly after thoracic surgery. This case emphasizes the successful use of VV-ECMO in posttraumatic ARDS without increasing the risk of bleeding.
静脉-静脉体外膜肺氧合（VV-ECMO）是治疗伴有难治性低氧血症的重症急性呼吸窘迫综合征（ARDS）的一种辅助治疗方法。在实施ECMO之前，必须排除治疗性抗凝的禁忌症。我们报告了一例17岁男性因多处枪伤导致穿透性胸部创伤入住重症监护病房（ICU）的病例。全身计算机断层扫描（全身CT扫描）显示右肺挫伤和同侧血胸。由于肺挫伤导致难治性低氧血症，他的病情迅速恶化，需要有创机械通气（IMV）和多次输血治疗的失血性休克。在他入住ICU期间，两次实施了静脉-静脉ECMO（VV-ECMO），第一次用于治疗创伤性ARDS，第二次用于胸外科手术后。该病例强调了VV-ECMO在创伤后ARDS中的成功应用，且未增加出血风险。
