1657: An Epidemiological Analysis of Extracorporeal Membrane Oxygenation Use in Trauma From 2017-2023

Introduction: According to the CDC, the leading cause of death in both children and young adults in the United States is trauma. Extracorporeal membrane oxygenation (ECMO) has been used in patients with severe trauma since the 1970’s. We sought to characterize the use of this form of advanced life support in trauma patients and better describe current practice patterns given its increased use for respiratory failure during the COVID19 pandemic. Methods: Utilizing data from the Trauma Quality Improvement Program database from 2017-2023, procedure codes were used to identify in which patients ECMO was used. We included both adult and pediatric patients and evaluated practice patterns and outcomes both overall and in these distinct populations. Pediatric patients were defined as less than 18 years of age. Descriptive and inferential statistical methods were used to analyze the data. Results: The use of ECMO was identified in 1,919 patients out of 8,014,737 encounters (0.02%). Within this group, 224 (11.7%) were < 18 years of age. The median time from hospital arrival to ECMO cannulation was 44 hours (IQR 5-147). The most common adult comorbidities among those cannulated were tobacco use, hypertension and diabetes. Survival ranged from 59-68% annually in all patients and 61-90% in pediatric patients. The number of facilities at which cannulation was performed annually ranged from 103-158 and steadily increased throughout the study period. Conclusions: ECMO use in trauma was infrequent but the number of performing facilities increased during the study period. Survival among these patients was similar to previous reports. Our findings will help inform future clinical guidelines and practice regarding the use of ECMO in this population.