Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases
Extracorporeal membrane oxygenation (ECMO) has become a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS). The management of orthopaedic trauma in ECMO-supported patients with ARDS remains an evolving area of interest. Orthopaedic injuries are often temporized with...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644024000438 |
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| author | Jaquelyn Kakalecik Amanda M. Frantz Michael T. Talerico Thomas A. Krupko Jennifer E. Hagen Matthew R. Patrick |
| author_facet | Jaquelyn Kakalecik Amanda M. Frantz Michael T. Talerico Thomas A. Krupko Jennifer E. Hagen Matthew R. Patrick |
| author_sort | Jaquelyn Kakalecik |
| collection | DOAJ |
| description | Extracorporeal membrane oxygenation (ECMO) has become a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS). The management of orthopaedic trauma in ECMO-supported patients with ARDS remains an evolving area of interest. Orthopaedic injuries are often temporized with external fixators, skeletal traction, or splints due to hemodynamic instability as well as concerns of exacerbating underlying pulmonary injury. However, patients requiring ECMO support do not rely on their pulmonary system for oxygenation, the need for delayed fixation may not apply. However, patients utilizing ECMO therapy can have external cardiac and pulmonary support depending on their cannulation strategy, bypassing the need for delayed fixation. We present a case series of two polytrauma patients with ARDS who underwent surgical management of pelvic ring and femoral shaft fractures while receiving ECMO support. Both patients underwent surgical management without complication and were able to be weaned from ECMO and ventilator support postoperatively. These cases highlight the potential benefits to orthopaedic fixation and underscore the need for further clinical research. |
| format | Article |
| id | doaj-art-d166bc9e8b8e4400a2de7711cb907212 |
| institution | Kabale University |
| issn | 2352-6440 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-d166bc9e8b8e4400a2de7711cb9072122025-08-20T03:47:09ZengElsevierTrauma Case Reports2352-64402024-06-015110102010.1016/j.tcr.2024.101020Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two casesJaquelyn Kakalecik0Amanda M. Frantz1Michael T. Talerico2Thomas A. Krupko3Jennifer E. Hagen4Matthew R. Patrick5Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA; Corresponding author at: Orthopaedics and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL 32611, USA.Department of Anesthesiology, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USADepartment of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USAExtracorporeal membrane oxygenation (ECMO) has become a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS). The management of orthopaedic trauma in ECMO-supported patients with ARDS remains an evolving area of interest. Orthopaedic injuries are often temporized with external fixators, skeletal traction, or splints due to hemodynamic instability as well as concerns of exacerbating underlying pulmonary injury. However, patients requiring ECMO support do not rely on their pulmonary system for oxygenation, the need for delayed fixation may not apply. However, patients utilizing ECMO therapy can have external cardiac and pulmonary support depending on their cannulation strategy, bypassing the need for delayed fixation. We present a case series of two polytrauma patients with ARDS who underwent surgical management of pelvic ring and femoral shaft fractures while receiving ECMO support. Both patients underwent surgical management without complication and were able to be weaned from ECMO and ventilator support postoperatively. These cases highlight the potential benefits to orthopaedic fixation and underscore the need for further clinical research.http://www.sciencedirect.com/science/article/pii/S2352644024000438PolytraumaEarly appropriate careExtracorporeal membrane oxygenationECMOOrthopaedic surgeryPelvis fracture |
| spellingShingle | Jaquelyn Kakalecik Amanda M. Frantz Michael T. Talerico Thomas A. Krupko Jennifer E. Hagen Matthew R. Patrick Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases Trauma Case Reports Polytrauma Early appropriate care Extracorporeal membrane oxygenation ECMO Orthopaedic surgery Pelvis fracture |
| title | Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases |
| title_full | Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases |
| title_fullStr | Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases |
| title_full_unstemmed | Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases |
| title_short | Orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation (ECMO): A report of two cases |
| title_sort | orthopaedic fracture surgery in polytraumatized patients while on extracorporeal membrane oxygenation ecmo a report of two cases |
| topic | Polytrauma Early appropriate care Extracorporeal membrane oxygenation ECMO Orthopaedic surgery Pelvis fracture |
| url | http://www.sciencedirect.com/science/article/pii/S2352644024000438 |
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