Portable ECMO for Battlefield Trauma: Bringing Critical Care to the Wounded
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What if the ICU could move toward the wounded patient instead of waiting for evacuation? In this lecture, Andriy Bachynskyi explores that idea through decades of work on portable extracorporeal life-support systems designed for trauma and austere environments.
The discussion moves from lessons of Iraq and Afghanistan to the very different realities of prolonged evacuation and tourniquet times in Ukraine. It covers VV versus VA ECMO, jugular double-lumen cannulation, ventilator-induced lung injury, early extracorporeal CO2 removal, metabolic acidosis, secondary lung injury after hemorrhagic shock, transport on ECMO and the difficult balance between thrombosis and anticoagulation in trauma.
The most forward-looking part is the shift from room-sized ECMO equipment toward compact, battery-powered systems that can support gas exchange and potentially integrate fluid removal, dialysis and other blood-processing modules. The Q&A adds practical discussion on cannulation without fluoroscopy, recirculation, renal replacement therapy, tourniquet syndrome and whether extracorporeal support could realistically move as far forward as Role 2 care.
The discussion moves from lessons of Iraq and Afghanistan to the very different realities of prolonged evacuation and tourniquet times in Ukraine. It covers VV versus VA ECMO, jugular double-lumen cannulation, ventilator-induced lung injury, early extracorporeal CO2 removal, metabolic acidosis, secondary lung injury after hemorrhagic shock, transport on ECMO and the difficult balance between thrombosis and anticoagulation in trauma.
The most forward-looking part is the shift from room-sized ECMO equipment toward compact, battery-powered systems that can support gas exchange and potentially integrate fluid removal, dialysis and other blood-processing modules. The Q&A adds practical discussion on cannulation without fluoroscopy, recirculation, renal replacement therapy, tourniquet syndrome and whether extracorporeal support could realistically move as far forward as Role 2 care.
TRAUMA-03
Course
Critical Care in Combat Trauma: Thoracic Injury, Respiratory Support, and ECMO
01
1:14:04 Now playing
Portable ECMO for Battlefield Trauma: Bringing Critical Care to the WoundedA lecture on moving extracorporeal life support beyond the ICU and closer to the point of injury. Andriy Bachynskyi discusses portable battery-powered ECMO, trauma physiology, lung-protective support, cannulation, transport and the challenges of using extracorporeal technologies in wounded patients.
02
1:08:27
Combat Trauma of the Heart and Chest: A Cardiovascular Surgeon’s PerspectiveA frontline-focused lecture on severe combat injuries of the heart, lungs and major vessels, with real operative cases, resuscitative thoracotomy, hemorrhage control and decision-making under limited resources.
03
45:12
Respiratory Failure in Combat Trauma: Role 1–Role 2 Principles and MonitoringA practical guide to airway management, mechanical ventilation, capnography, and safe evacuation of combat trauma patients, grounded in real Role 2 experience.
04
39:56
ECMO in Trauma and Critical Care: From Circuit Basics to a Combat Injury CaseA practical introduction to VV- and VA-ECMO: circuit components, cannulation, patient selection, complications, key evidence, and a real combat trauma case with severe ARDS.
05
1:29:00
Combat-Related Heart InjuriesA practical lecture on combat-related cardiac trauma: evacuation priorities, diagnostic pitfalls, operative access, myocardial repair, and the difficult decisions surrounding intracardiac foreign bodies.
06
31:34
Diagnosis and Minimally Invasive Management of Combat Esophageal InjuriesA practical review of combat-related esophageal injuries, from early diagnostic suspicion and CT trajectory analysis to endoscopy, thoracoscopy, laparoscopy, and minimally invasive repair in carefully selected patients.
Portable ECMO for Battlefield Trauma: Bringing Critical Care to the Wounded