The Impact of an Advanced ECMO Program on Traumatically Injured Patients
April A. Grant
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorValerie J. Hart
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorEdward B. Lineen
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorCynthia Lai
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorEnrique Ginzburg
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorDouglas Houghton
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorCarl I. Schulman
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorRodrigo Vianna
Division of Liver, Intestinal and Multivisceral Transplant, Miami Transplant Institute, Miami, FL, USA
Dewitt Daughtry Family Department of Surgery, Division of Liver, Intestinal and Multivisceral Transplant, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorAmit N. Patel
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorAmelia Casalenuovo
Department of Pharmacy, Jackson Health System, Miami, FL, USA
Search for more papers by this authorMatthias Loebe
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Thoracic Transplantation and Mechanical Circulatory Support, Miami Transplant Institute, Miami, FL, USA
Search for more papers by this authorCorresponding Author
Ali Ghodsizad
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Thoracic Transplantation and Mechanical Circulatory Support, Miami Transplant Institute, Miami, FL, USA
Address correspondence and reprint requests to Ali Ghodsizad, MD, PhD, FACC, FETCS, Assistant Professor, Surgical Director, ECMO program, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, 1801 NW 9th Ave, 6th Floor, Miami, FL 33136, USA. E-mail: [email protected]Search for more papers by this authorApril A. Grant
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorValerie J. Hart
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorEdward B. Lineen
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorCynthia Lai
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorEnrique Ginzburg
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorDouglas Houghton
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorCarl I. Schulman
Dewitt Daughtry Family Department of Surgery, Division of Trauma, Surgical Critical Care and Burns, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Trauma and Acute Care Surgery, Jackson Health System & Ryder Trauma Center, Miami, FL, USA
Search for more papers by this authorRodrigo Vianna
Division of Liver, Intestinal and Multivisceral Transplant, Miami Transplant Institute, Miami, FL, USA
Dewitt Daughtry Family Department of Surgery, Division of Liver, Intestinal and Multivisceral Transplant, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorAmit N. Patel
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorAmelia Casalenuovo
Department of Pharmacy, Jackson Health System, Miami, FL, USA
Search for more papers by this authorMatthias Loebe
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Thoracic Transplantation and Mechanical Circulatory Support, Miami Transplant Institute, Miami, FL, USA
Search for more papers by this authorCorresponding Author
Ali Ghodsizad
Dewitt Daughtry Family Department of Surgery, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
Division of Thoracic Transplantation and Mechanical Circulatory Support, Miami Transplant Institute, Miami, FL, USA
Address correspondence and reprint requests to Ali Ghodsizad, MD, PhD, FACC, FETCS, Assistant Professor, Surgical Director, ECMO program, Division of Cardiothoracic Surgery, University of Miami, Leonard M. Miller School of Medicine, 1801 NW 9th Ave, 6th Floor, Miami, FL 33136, USA. E-mail: [email protected]Search for more papers by this authorAbstract
In June 2016, an advanced extracorporeal membrane oxygenation (ECMO) program consisting of a multidisciplinary team was initiated at a large level-one trauma center. The program was created to standardize management for patients with a wide variety of pathologies, including trauma. This study evaluated the impact of the advanced ECMO program on the outcomes of traumatically injured patients undergoing ECMO. A retrospective cohort study was performed on all patients sustaining traumatic injury who required ECMO support from January 2014 to September 2017. The primary outcome was to determine survival in trauma ECMO patients in the two timeframes, before and after initiation of the advanced ECMO program. Secondary outcomes included complication rates, length of stay, ventilator usage, and ECMO days. One hundred and thirty eight patients were treated with ECMO during the study period. Of the 138 patients, 22 sustained traumatic injury. Seven patients were treated in our pre-group and 15 in our post-group. The majority of patients were treated with VV ECMO. Our post group VV ECMO extracorporeal survival rate was 64% and our survival to discharge was 55%. This study demonstrated an improvement in survival after implementation of our advanced ECMO program. The implementation of a multidisciplinary trauma ECMO team dedicated to the rescue of critically ill patients is the key for achieving excellent outcomes in the trauma population.
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