Case Report ApplicationofHybridExtracorporealMembraneOxygenationfor theTreatmentofSubsequentShockfollowingAcuteRespiratory Distress Syndrome Developing after Firearm Injury YahyaYildiz, 1 DidemMelisOztas, 2 MustafaOzerUlukan, 3 KorhanErkanli, 3 OrcunUnal, 4 Murat Ugurlucan , 3 andHalilTurkoglu 3 1 Istanbul Medipol University Medical Faculty, Department of Anesthesiology, Istanbul, Turkey 2 Bagcilar Training and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey 3 Istanbul Medipol University Medical Faculty, Department of Cardiovascular Surgery, Istanbul, Turkey 4 Yedikule Chest Diseases and oracic Surgery Education and Research Hospital, Cardiovascular Surgery Clinic, Istanbul, Turkey Correspondence should be addressed to Murat Ugurlucan; muratugurlucan@yahoo.com Received 25 May 2019; Revised 6 September 2019; Accepted 1 October 2019; Published 4 December 2019 Academic Editor: Bruno Megarbane Copyright © 2019 Yahya Yildiz et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. e use of extracorporeal membrane oxygenation (ECMO) in acute respiratory distress syndrome (ARDS) and cardio-circulatory shock has been widely accepted. In recent years, a variety of novel and exceptional indications for ECMO have been proposed; however, experience with ECMO use in the presence of multiple penetrating injuries is limited. In this report, we present successful ECMO application in a patient with multiple firearm injuries. Veno-venous ECMO was applied for ARDS and converted to the venoarterial mode when the patient developed septic cardiomyopathy. e clinical status of the patient gradually improved, and the patient was discharged from the hospital after 24 days, successfully. 1.Introduction Worldwide extracorporeal membrane oxygenation (ECMO) use has increased for the treatment of refractory patients with acute respiratory distress syndrome (ARDS). It is applied with reasonable mortality and morbidity rates to support mechanical ventilation (MV) [1]. Prolonged and high-pressure mechanical ventilation has certain risks for the pulmonary system. e veno-venous (V-V) ECMO supports patients in such critical conditions with facilitated carbon dioxide clearance and oxygenation; hence, mor- tality and morbidity secondary to ARDS may be attenuated [2–4]. ECMO has also use in polytrauma patients; however, experience is limited especially due to the high risk of major uncontrollable bleeding. In addition, the success of ECMO is relatively better in case of pulmonary trauma when com- pared with other organ systems including brain and spinal cord injuries [5]. In this report, we present our successful ECMO expe- rience in a patient with multiple gunshot injuries. 2.CaseReport A 45-year-old male patient was brought to the emergency department at 01:00 a.m. in unconscious status with multiple gunshot injuries. He weighed 70 kg and was 168 cm tall. e patient was paraplegic. One of the bullets entered from the left arm pit and left the body from the right scapula. ere was another bullet entrance from the right upper abdominal quadrant. His relatives did not present any history of previous medical issues or regular use of medi- cations. Chest roentgenogram and computerized tomogra- phy scans indicated hemopneumothorax in the left hemithorax with destruction of the upper lobe of the left lung. In addition, the vertebral corpuses of T4 and T5 were severely destructed. ere were liver and spleen injuries with intra-abdominal fluid accumulation. Hindawi Case Reports in Medicine Volume 2019, Article ID 3120912, 4 pages https://doi.org/10.1155/2019/3120912