Extracorporeal Membrane Oxygenation for Traumatic Acute Respiratory Distress Syndrome in a Child

Acute respiratory distress syndrome (ARDS) represents acute and rapidly progressive bilateral pulmonary infiltrates, which present on chest radiography. Although conventional mechanical ventilation is used, oxygen toxicity and ventilator-induced injury have increased mortality rates for pediatric patients by 84-89 %. Trauma has been responsible for ARDS in only one fourth of patients treated with extracorporeal membrane oxygenation (ECMO). The management of severe pulmonary contusions in trauma patients with multiple injuries can be extremely challenging for clinicians. ECMO is an alternative supportive therapy for severe ARDS. The application of ECMO to children achieved a survival rate of 50% in an otherwise nonsalvageable group of patients. The advantage of ECMO is that it allows blood oxygenation at a far lower FiO2, lower positive end-expiratory pressure and peak inspiratory pressure, and decreases the risk of barotrauma and oxygen toxicity. We report an 8-year-old boy who had been involved in a high-speed car crash, sustaining left kidney laceration grade V. Traumatic ARDS was noted during postoperative days 2 and 3. Because no causal therapy is available for ARDS, therapy is only supportive. When conventional treatment modalities fail, the patient may be a candidate for ECMO. ECMO with heparin-bonded circuitry offers supplemental capability while the primary injuries are being evaluated and treated. Our patient recovered and his other symptoms improved without complications within a 10-month follow-up period.

並列關鍵字

ECMO ； traumatic ARDS

國際替代計量

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