PMID- 29447407
OWN - NLM
STAT- MEDLINE
DCOM- 20191119
LR  - 20191119
IS  - 1930-613X (Electronic)
IS  - 0026-4075 (Linking)
VI  - 183
IP  - 9-10
DP  - 2018 Sep 1
TI  - The Feasibility of Venovenous ECMO at Role-2 Facilities in Austere Military 
      Environments.
PG  - e644-e648
LID - 10.1093/milmed/usx132 [doi]
AB  - INTRODUCTION: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been 
      gaining use to bridge the recovery from acute respiratory distress syndrome 
      (ARDS) refractory to conventional treatment. However, these interventions are 
      often limited to higher echelons of military care. We present a case of lung 
      salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) 
      facility in an austere military environment in Afghanistan. CASE: A 25-year-old 
      Afghani soldier presented to an R2 facility with blast lung injury and multiple 
      penetrating injuries following an explosion. The patient underwent immediate 
      damage control laparotomy. The abdomen was left open for subsequent washouts and 
      ongoing resuscitation. Due to his ineligibility for evacuation and worsening 
      ARDS, despite 5 d of conventional ventilation strategies, he was started on 
      VV-ECMO. The patient had immediate improvements in oxygenation, which continued 
      for 10 d. Moreover, he underwent three transportations to the operating room 
      without accidental decannulation or disruption of the VV-ECMO device. Despite 
      significant improvements, the patient expired on postoperative day 15, due to an 
      overwhelming intra-abdominal sepsis. CONCLUSION: As future advancements are 
      sought, VV-ECMO may become a consideration for casualties with severe ARDS at the 
      point of injury and at lower echelons of military care.
CI  - (c) Association of Military Surgeons of the United States 2018. All rights 
      reserved. For permissions, please e-mail: journals.permissions@oup.com.
FAU - Mohamed, Mohamed A T
AU  - Mohamed MAT
AD  - Department of Surgery, Michigan State University College of Human Medicine, Eyde 
      Building, Suite 600, 4660 S. Hagadorn Road, East Lansing, MI.
FAU - Maraqa, Tareq
AU  - Maraqa T
AD  - Department of Trauma, Hurley Medical Center, 1 Hurley Plaza, Flint, MI.
FAU - Bacchetta, Matthew D
AU  - Bacchetta MD
AD  - Department of Surgery, New York-Presbyterian Hospital/Columbia University Medical 
      Center, 161 Fort Washington Avenue, 3rd floor, New York, NY.
FAU - McShane, Michael
AU  - McShane M
AD  - United States Army Reserve Command, 4710 Knox St., Fort Bragg, NC.
FAU - Wilson, Kenneth L
AU  - Wilson KL
AD  - Department of Surgery, University of Chicago, 5841 S. Maryland Avenue, Chicago, 
      IL.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Mil Med
JT  - Military medicine
JID - 2984771R
SB  - IM
MH  - Adult
MH  - Afghanistan/ethnology
MH  - Blast Injuries/epidemiology/ethnology
MH  - Extracorporeal Membrane Oxygenation/*methods/trends
MH  - Feasibility Studies
MH  - Humans
MH  - Lung Injury/epidemiology/ethnology/*therapy
MH  - Male
MH  - Military Personnel/*statistics & numerical data
OTO - NOTNLM
OT  - ARDS
OT  - Acute Lung Failure
OT  - Acute Respiratory Distress Syndrome
OT  - BLI
OT  - Blast Lung Injury
OT  - Combat
OT  - ECMO
OT  - Extracorporeal Membrane Oxygenation
OT  - Trauma
EDAT- 2018/02/16 06:00
MHDA- 2019/11/20 06:00
CRDT- 2018/02/16 06:00
PHST- 2017/07/31 00:00 [received]
PHST- 2017/10/18 00:00 [revised]
PHST- 2017/11/23 00:00 [accepted]
PHST- 2018/02/16 06:00 [pubmed]
PHST- 2019/11/20 06:00 [medline]
PHST- 2018/02/16 06:00 [entrez]
AID - 4852797 [pii]
AID - 10.1093/milmed/usx132 [doi]
PST - ppublish
SO  - Mil Med. 2018 Sep 1;183(9-10):e644-e648. doi: 10.1093/milmed/usx132.