Bonacchi et al evaluated patients with poly-trauma for therapy with extracorporeal life support (ECLS), They identified factors predictive of ECLS failure in this population. The authors are from Florence, Italy.
Indications: polytrauma with refractory pulmonary/cardiopulmonary failure
In experienced hands ECLS can result in normalization of oxygenation and blood lactate within a few hours.
Parameters:
(1) injury severity score (ISS)
(2) arterial pH (mean of 3 measurements)
(3) blood lactate in mmol/L
Parameter
Finding
Points
ISS
<= 63
0
> 63
1
arterial pH
>= 7.01
0
< 7.01
1
blood lactate
<= 14.4 mmol/L
0
> 14.4 mmol/L
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 1 was associated with ECLS failure.
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