Successful treatment of an adult with severe chest trauma under extracorporeal membrane oxygenation: a case report / 中华危重病急救医学

ABSTRACT

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a valuable treatment option for chest trauma individuals and some patients required surgery. A 35-year-old female patient with severe chest trauma was admitted to Affiliated Hospital of Zunyi Medical University on February 27, 2020. The patient was hospitalized with chest pain and dyspnea due to fall from a height. Emergency chest CT revealed a right fluid pneumothorax (60% of right lung compression), left hemothorax, little pericardial effusion, and multiple emphysemas in the lower neck, chest, back and mediastinum. Invasive ventilator was difficult to maintain oxygen saturation. After evaluation, the VV-ECMO was established, then, she received a thoracotomy. There was a 1.2 cm trachea rupture observed during operation, and the trachea was repaired. The operation lasted 4 hours with the continuous support of VV-ECMO. When the patient's haemodynamics and oxygenation was stable, ECMO was removed. Sixteen days later, the patient's chest CT showed that, the chest wall subcutaneous emphysema was reduced, and the exudative lesions of both lungs were absorbed, indicating that the patient was treated effectively and reached the discharge standard with no complication. During the treatment of this patient, VV-ECMO was applied rapidly and lasted for a short period, which provided the patient with the opportunity of emergency operation and finally the patient was fully recovered. VV-ECMO can provide support for patients with severe trauma and refractory hypoxemia.