Extracorporeal membrane oxygenation in severe respiratory failure resulting from burns and smoke inhalation injury Lajos Szentgyorgyi a , Chloe Shepherd a , Ken W. Dunn b, d , Peter Fawcett a , Julian M. Barker a, d , Paul Exton a , Marc O. Maybauer a, c, d, e, f , * a Cardiothoracic Anaesthesia and Intensive Care, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK b North West Regional Burn Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK c Cardiothoracic Anaesthesia and Intensive Care, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK d Manchester University and Manchester Academic Health Science Centre, Manchester, UK e The University of Queensland, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia f Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany a b s t r a c t Extracorporeal membrane oxygenation (ECMO) is one of the most frequent forms of extracorporeal life support (ECLS) and can be used as rescue therapy in patients with severe respiratory failure resulting from burns and/or smoke inhalation injury. Experience and literature on this treatment option is still very limited, consequently results are varied. We report a retrospective analysis of our experience with veno-venous (VV) ECMO in burn patients. All five patients, three male and two female (age: 28 –37 years) had flame type burns and smoke inhalation injury. Their Murray scores ranged between 3.25 and 3.75, and their revised Baux scores between 62 and 102. The mean pre-ECMO conventional ventilation time was 7.4days (3 – 13). The mean ECMO duration was 18days (8 –35). Three patients were cannulated with dual lumen, two with separate cannulae. One oxygenator had to be changed due to technical issues and two patients needed two parallel oxygenators. Four patients had renal replacement therapy. All patients needed vasoconstrictor support, antibiotics and packed red blood cells (5 – 62 units). Three had steroid treatment. All five patients were successfully weaned from ECMO. One patient died later from multi-organ failure in the ICU, the other four patients survived. VV- ECMO is a useful rescue intervention in patients with burns related severe respiratory failure. Patients in our institution benefit from having both burns and ECMO centres with major expertise in the field under one roof. The results from this small cohort are encouraging, although more cases are needed to draw more robust conclusions. © 2018 Elsevier Ltd and ISBI. All rights reserved. a r t i c l e i n f o Article history: Accepted 31 January 2018 Available online xxx Keywords: ARDS ECLS ECMO Sepsis Shock * Corresponding author at: Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK. E-mail addresses: m.maybauer@uq.edu.au, marc.maybauer@mft.nhs.uk (M.O. Maybauer). https://doi.org/10.1016/j.burns.2018.01.022 0305-4179/© 2018 Elsevier Ltd and ISBI. All rights reserved. b u r n s x x x ( 2 0 1 8 ) x x x – x x x JBUR 5479 No. of Pages 9 Please cite this article in press as: L. Szentgyorgyi, et al., Extracorporeal membrane oxygenation in severe respiratory failure resulting from burns and smoke inhalation injury, Burns (2018), https://doi.org/10.1016/j.burns.2018.01.022 Available online at www.sciencedirect.com ScienceDirect jo u rn al h o mep age: w ww .elsevier .co m /loc ate/b u rn s