Prolonged Extracorporeal Oxygenation for Acute Post-Traumatic Respiratory Failure (Shock-Lung Syndrome)

Abstract

A 24-year-old man sustained subadventitial transection of the thoracic aorta and multiple orthopedic injuries resulting from blunt trauma. The aortic injury was repaired. Because respiratory failure occurred four days later and worsened despite maximal conventional supportive therapy, partial venoarterial perfusion with peripheral cannulation, with use of the Bramson-membrane heart-lung machine, was initiated and continued for 75 hours. At a by-pass flow of 3.0 to 3.6 liters per minute, oxygen tension increased from 38 to 75 mm of mercury, inspired oxygen concentration was reduced from 100 to 60 per cent, and peak airway pressure decreased from 60 to 35 cm of water. The shock-lung syndrome was reversed, and the patient recovered.