25 - EARLY USE OF EXTRACORPOREAL MEMBRANE OXYGENATION IN TRAUMATICALLY INJURED PATIENTS: A TRAUMA QUALITY IMPROVEMENT PROGRAM DATABASE ANALYSIS

Objectives: Extracorporeal membrane oxygenation (ECMO) use in trauma patients remains a rare and poorly characterized event. While ECMO most commonly has been deployed for cardiopulmonary or respiratory failure following the initial resuscitative phases, growing levels of evidence for out of hospital cardiac arrest support early ECMO cannulation as part of the resuscitative efforts. The objective of this study was to perform a descriptive analysis evaluating traumatically injured patients who were placed on ECMO during their initial resuscitation period.

Methods: We performed a retrospective analysis of the Trauma Quality Improvement Program Database from 2017 to 2019. All traumatically injured patients who received ECMO within the first 24 hours of their hospitalization were assessed. Descriptive statistics were used to define patient characteristics and injury patterns associated with the need for ECMO, while mortality data represented the primary outcome evaluated.

Results: A total of 810 trauma patients received ECMO during their hospitalization, of which 243 patients were placed on ECMO within the first 24 hours. Patients were on average 32 years old, 83% male, and sustained a penetrating injury 9% of the time. The average ISS was 30.6 and the overall mortality rate was 38.7%. Prehospital cardiac arrest was noted in 17.3% of the patient population resulting in a 64.1% mortality. Of those with prehospital cardiac arrest who underwent early ECMO cannulation for blunt injury patterns, a 37.1% survival rate to discharge was demonstrated.

Conclusion: Early cannulation for ECMO in severely injured patients may provide an opportunity for rescue therapy following severe injury patterns. Further evaluation regarding the safety profile, cannulation strategies, and optimal injury patterns for these techniques should be evaluated.