ECMO in Trauma and Critical Care: From Circuit Basics to a Combat Injury Case
ECMO is more than an oxygenator and a pump—it is a temporary bridge that demands precise patient selection, correct cannula positioning, and a team prepared for rapidly changing physiology.
This lecture explains how VV-ECMO supports the lungs, how VA-ECMO supports circulation, and why cannula diameter, blood flow, recirculation, temperature control, and anticoagulation directly affect clinical results. Indications and contraindications are discussed through severe ARDS, refractory cardiogenic shock, ECPR, thoracic trauma, and bridging to lung transplantation, alongside evidence from major ECMO trials.
A real case of a 28-year-old serviceman with mine-blast trauma, extensive lung injury, severe respiratory failure, and multidrug-resistant infection connects the physiology to bedside decisions. The closing discussion explores ECMO after pneumonectomy, anticoagulation during active bleeding, and why this technology belongs in experienced multidisciplinary centres rather than simply wherever cannulation is technically possible.
This lecture explains how VV-ECMO supports the lungs, how VA-ECMO supports circulation, and why cannula diameter, blood flow, recirculation, temperature control, and anticoagulation directly affect clinical results. Indications and contraindications are discussed through severe ARDS, refractory cardiogenic shock, ECPR, thoracic trauma, and bridging to lung transplantation, alongside evidence from major ECMO trials.
A real case of a 28-year-old serviceman with mine-blast trauma, extensive lung injury, severe respiratory failure, and multidrug-resistant infection connects the physiology to bedside decisions. The closing discussion explores ECMO after pneumonectomy, anticoagulation during active bleeding, and why this technology belongs in experienced multidisciplinary centres rather than simply wherever cannulation is technically possible.