Extracorporeal membrane oxygenation in traumatic brain injury-A retrospective, multicenter cohort study

Introduction: Patients with traumatic brain injury (TBI) regularly require intensive care with prolonged in-vasive ventilation. Consequently, these patients are at increased risk of pulmonary failure, potentially re-quiring extracorporeal membrane oxygenation (ECMO). The aim of this work was to provide an overview of ECMO treatment in TBI patients based upon data captured into the TraumaRegister DGU & REG; (TR-DGU).Methods: A retrospective multi-center cohort analysis of patients registered in the TR-DGU was con-ducted. Adult patients with relevant TBI (AISHead & GE;3) who had been treated in German, Austrian, or Swiss level I or II trauma centers using ECMO therapy between 2015 and 2019 were included. A multivariable logistic regression analysis was used to identify risk factors for the need for ECMO treatment.Results: 12,247 patients fulfilled the inclusion criteria. The overall rate of ECMO treatment was 1.1% (134 patients). Patients on ECMO had an overall hospital mortality rate of 38% (51/134 patients) while 13% (1523/12,113 patients) of TBI patients without ECMO therapy died. Male gender ( p = 0.014), AISChest 3 + ( p < 0.001), higher Injury Severity Score ( p < 0.001) and packed red blood cell (pRBC) transfusion ( p < 0.001) were associated with ECMO treatment. Conclusion: ECMO therapy is a potentially lifesaving modality for the treatment of moderate-to-severe TBI when combined with severe chest trauma and pulmonary failure. The in-hospital mortality is increased in this high-risk population, but the majority of patients is surviving.& COPY; 2023 Elsevier Ltd. All rights reserved.

Automated summary

Patients with TBI often require invasive ventilation, putting them at risk of pulmonary failure and potential need for ECMO treatment. This study provides an overview of ECMO treatment in TBI patients based on data from the TraumaRegister DGU. The results show that while the mortality rate is higher in patients receiving ECMO, the majority of patients survive.