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다발성 외상으로 인한 심한 폐 좌상과 스트레스성 심근병 환자에서 체외막형 산화기의 치료 경험
이대상 ( Dae Sang Lee ),길은미 ( Eun Mi Gil ),이아란 ( A Lan Lee ),하태순 ( Tae Sun Ha ),정치량 ( Chi Ryang Chung ),박치민 ( Chi Min Park ),조양현 ( Yang Hyun Cho ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4
A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient’s gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure. [ J Trauma Inj 2014; 27: 229-32 ]