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Selective Use of Cardiopulmonary Bypass in Trauma Patients

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The need for cardiopulmonary bypass (CPB) in the treatment of trauma patients is controversial, and not all level I trauma centers have CPB readily available. Our purpose was to review the selective use of CPB in the management of trauma victims at a level I trauma center in Los Angeles County. We reviewed the records of all patients for whom the CPB team was called in from 1994 to 2002. Perfusionists were present for the initial operative management of 24 patients, 22 (92%) of which were male. Twelve patients had penetrating and nine had blunt injuries, two were severely hypothermic, and the last suffered embolization of a bullet to the pulmonary artery. Overall survival was 75 per cent. Sixteen (67%) patients required CPB due to the life-threatening nature of their injuries and/or hemodynamic instability; 11 (69%) survived. The remaining 8 patients were operated on with the CPB team present but on standby; 7 (88%) survived. Cardiopulmonary bypass could be life-saving in select trauma patients with major chest injuries. Hypothermia, acidemia, and shock can be reversed earlier while allowing increased time to gain adequate exposure and perform quality repairs. Level I trauma centers should have CPB capabilities immediately available.
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Keywords: Research Article

Document Type: Research Article

Publication date: January 1, 2005

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  • The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
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