Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol
Abstract Severe burn injuries complicated by acute respiratory failure present unique challenges in critical care medicine. Although the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) can offer life-saving support for this patient cohort, the perioperative management of burn patie...
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BMC
2025-08-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-025-00572-2 |
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| author | Sonja Verena Schmidt Elisabete Macedo Santos Marius Drysch Flemming Puscz Felix Reinkemeier Dirk Buchwald Peter K. Zahn Marcus Lehnhardt Jannik Hinzmann Christoph Wallner |
| author_facet | Sonja Verena Schmidt Elisabete Macedo Santos Marius Drysch Flemming Puscz Felix Reinkemeier Dirk Buchwald Peter K. Zahn Marcus Lehnhardt Jannik Hinzmann Christoph Wallner |
| author_sort | Sonja Verena Schmidt |
| collection | DOAJ |
| description | Abstract Severe burn injuries complicated by acute respiratory failure present unique challenges in critical care medicine. Although the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) can offer life-saving support for this patient cohort, the perioperative management of burn patients on ECMO remains poorly standardized, and evidence-based guidelines are lacking. This perspective outlines the experiences gained from managing burn patients undergoing surgery while on V-V ECMO at a major burn center. Over a 3-year period, 14 patients with an average burned total body surface area (TBSA) involvement of 41% were treated with ECMO support. Several key strategies contributed to the safe surgical management of these patients. Looking ahead, there is a clear need for multicenter registry data and collaborative efforts to establish standardized perioperative protocols for burn patients receiving ECMO. Individualized anticoagulation management using point-of-care techniques such as thromboelastography, and the evaluation of optimal surgical timing strategies, will be essential areas for future research. In conclusion, interdisciplinary teamwork and structured perioperative management protocols can enable safe surgical treatment of burn patients on ECMO. Broader collaboration and standardized data collection are crucial steps to improving outcomes and establishing best practices for this complex patient population. |
| format | Article |
| id | doaj-art-d699ae5296344e98b50b0721c8789a07 |
| institution | Kabale University |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj-art-d699ae5296344e98b50b0721c8789a072025-08-24T11:41:27ZengBMCPerioperative Medicine2047-05252025-08-011411510.1186/s13741-025-00572-2Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocolSonja Verena Schmidt0Elisabete Macedo Santos1Marius Drysch2Flemming Puscz3Felix Reinkemeier4Dirk Buchwald5Peter K. Zahn6Marcus Lehnhardt7Jannik Hinzmann8Christoph Wallner9Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Anesthesiology, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Cardiothoracic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Anesthesiology, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumAbstract Severe burn injuries complicated by acute respiratory failure present unique challenges in critical care medicine. Although the use of veno-venous extracorporeal membrane oxygenation (V-V ECMO) can offer life-saving support for this patient cohort, the perioperative management of burn patients on ECMO remains poorly standardized, and evidence-based guidelines are lacking. This perspective outlines the experiences gained from managing burn patients undergoing surgery while on V-V ECMO at a major burn center. Over a 3-year period, 14 patients with an average burned total body surface area (TBSA) involvement of 41% were treated with ECMO support. Several key strategies contributed to the safe surgical management of these patients. Looking ahead, there is a clear need for multicenter registry data and collaborative efforts to establish standardized perioperative protocols for burn patients receiving ECMO. Individualized anticoagulation management using point-of-care techniques such as thromboelastography, and the evaluation of optimal surgical timing strategies, will be essential areas for future research. In conclusion, interdisciplinary teamwork and structured perioperative management protocols can enable safe surgical treatment of burn patients on ECMO. Broader collaboration and standardized data collection are crucial steps to improving outcomes and establishing best practices for this complex patient population.https://doi.org/10.1186/s13741-025-00572-2ECMOBurn surgeryAnticoagulationPerioperative medicineIntensive care |
| spellingShingle | Sonja Verena Schmidt Elisabete Macedo Santos Marius Drysch Flemming Puscz Felix Reinkemeier Dirk Buchwald Peter K. Zahn Marcus Lehnhardt Jannik Hinzmann Christoph Wallner Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol Perioperative Medicine ECMO Burn surgery Anticoagulation Perioperative medicine Intensive care |
| title | Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol |
| title_full | Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol |
| title_fullStr | Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol |
| title_full_unstemmed | Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol |
| title_short | Management of burn patients undergoing surgery while on extracorporeal membrane oxygenation (ECMO): clinical experience and a standardized perioperative protocol |
| title_sort | management of burn patients undergoing surgery while on extracorporeal membrane oxygenation ecmo clinical experience and a standardized perioperative protocol |
| topic | ECMO Burn surgery Anticoagulation Perioperative medicine Intensive care |
| url | https://doi.org/10.1186/s13741-025-00572-2 |
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