Application of veno-venous extracorporeal membrane oxygenation without heparin in a patient with combined trauma

Objective - to discuss the possibilities of extracorporeal life support in patients with trauma profile. Materials and methods. Patient K., female, age of 19, received a severe concomitant injury as result of a road traffic accident. On September 26, 2019, the fourth day after the road traffic accident, she was transferred from the level 2 trauma center (central regional hospital) to the level 1 trauma central where she had received six days of veno-venous extracorporeal membrane oxygenation (VV-ECMO) at the background of severe respiratory failure with extremely severe condition after the concomitant injury, unstable hemodynamics and metabolic disorders. Results. This report presents a clinical case of successful use of VV-ECMO in a victim with severe concomitant injury with severe acute respiratory distress syndrome (ARDS) on the 5th day of the injury. The peculiarity of the case was refusal from systemic anticoagulation due to the risk of hemorrhagic complications. On the day 6, the patient was successfully weaned from VV-ECMO, and on the day 4, after being disconnected from VV-ECMO, the patient underwent osteosynthesis of the lower leg bones. On the 7th after the operation, the patient was discharged from the hospital at the place of residence in a satisfactory condition. We described the case of successful use of VV-ECMO without heparin in the patient with severe concomitant injury complicated by the development of ARDS. Conclusion. VV-ECMO can serve as an additional treatment method for adult patients with severe closed lung injury or acute respiratory failure resistant to traditional ventilation. In patients with severe chest trauma and concomitant hemorrhagic shock, if closely monitored, V V-ECMO can be a safe and effective life-saving method