ECMO in the Burn Patient: the Time Has Come

Current Trauma Reports - Tập 5 - Trang 154-159 - 2019
April A. Grant1, Ali Ghodsizad2,3, Walter Ingram4
1Department Trauma Surgery and Surgical Critical Care, Emory University School of Medicine and Grady Hospital System, Atlanta, USA
2Dewitt Daughtry Family Department of Surgery, Division of Thoracic Transplantation and Mechanical Circulatory Support, University of Miami, Leonard M. Miller School of Medicine, Miami, USA
3Division of Thoracic Transplantation and Mechanical Circulatory Support, Miami Transplant Institute, Miami, USA
4Department Burn Surgery, Emory University School of Medicine and Grady Hospital, Atlanta, USA

Tóm tắt

The use of extracorporeal life support in the intensive care unit has exponentially increased in the last decade. Initially, its use in the burn population lagged behind the dramatic growth in other patient populations; however, in the last 2–3 years, there has been an increase in the number of publications related to its use in this population. In this article, we review the use of contemporary ECMO in the burn patient population and discuss future trends. Level 1 evidence for the use of ECMO in any patient population is scarce, and there is no level 1 evidence for the use of ECMO in burn patients. Recently, there has been an increase in case series and case reports describing the use of contemporary ECMO in burn patients. In addition, there are two large retrospective reviews of large registries utilizing ECMO in burn patients. The results from these studies all indicate that outcomes using ECMO in this critically ill patient population has survival rates at least comparable to the survival found in other patient populations. There are still many unanswered questions, and future focus needs to address patient selection, timing of initiation, management, and the duration of ECMO therapy.

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