{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:13:00Z","timestamp":1745467980059,"version":"3.40.4"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Acute Respiratory Distress Syndrome (ARDS) is a known and severe complication of thoracic trauma. Many patients, despite appropriate ventilator and medical support, continue to worsen requiring additional cardiopulmonary support with extracorporeal membrane oxygenation (ECMO). Additionally, obesity adds a layer of complexity in the management of trauma ARDS on ECMO. We describe the first U.S. Military air transportation mission via Critical Care Air Transport (CCAT) involving the cannulation and transportation of 2 obese trauma patients requiring ECMO support. We reviewed a cohort of 2 obese patients with ARDS secondary to trauma cannulated for venovenous ECMO and simultaneously transferred via Critical Care Air Transport to a DoD ECMO Center. We describe the logistics involved in the transport and management of obese trauma patients on ECMO. Both patients were safely cannulated and transported without complications, and survived their ECMO run and hospital stay. This is the first air transport of 2 obese ECMO patients simultaneously in U.S. Military history. This transport highlights the safety of cannulation and transportation of obese trauma patients, in addition to the flexibility and logistics needed to successfully complete an ECMO military transport.<\/jats:p>","DOI":"10.1093\/milmed\/usaf045","type":"journal-article","created":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T08:29:51Z","timestamp":1740212991000},"page":"e1309-e1313","source":"Crossref","is-referenced-by-count":0,"title":["Double the Trouble: Successful Cannulation and Air Transportation of Two Obese Trauma Patients Requiring Extracorporeal Membrane Oxygenation"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1028-9967","authenticated-orcid":false,"given":"Steven T","family":"Stoffel","sequence":"first","affiliation":[{"name":"Pulmonary\/Critical Care Service, Department of Medicine, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah A","family":"Juhasz","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew E","family":"Wood","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodor","family":"Danciu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda R","family":"Wiggins","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika R","family":"O\u2019Neil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik S","family":"Manninen","sequence":"additional","affiliation":[{"name":"United States Army Institute of Surgical Research , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,22]]},"reference":[{"issue":"10","key":"2025042308422858300_R1","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1097\/00003246-199510000-00007","article-title":"Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome","volume":"23","author":"Marshall","year":"1995","journal-title":"Crit Care Med"},{"issue":"2","key":"2025042308422858300_R2","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/01.CCM.0000108870.09693.42","article-title":"Effect of acute lung injury and acute respiratory distress syndrome on outcome in critically ill trauma patients","volume":"32","author":"Treggiari","year":"2004","journal-title":"Crit Care Med"},{"issue":"16","key":"2025042308422858300_R3","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1056\/NEJMoa050333","article-title":"Incidence and outcomes of acute lung injury","volume":"353","author":"Rubenfeld","year":"2005","journal-title":"N Engl J Med"},{"key":"2025042308422858300_R4","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1164\/rccm.201703-0548ST","article-title":"An official American Thoracic Society\/European Society of Intensive Care Medicine\/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome","volume":"195(9)","author":"Fan","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2025042308422858300_R5","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone positioning in severe acute respiratory distress syndrome","volume":"368(23)","author":"Gu\u00e9rin","year":"2013","journal-title":"N Engl J Med"},{"issue":"1","key":"2025042308422858300_R6","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-019-0540-9","article-title":"Formal guidelines: management of acute respiratory distress syndrome","volume":"9","author":"Papazian","year":"2019","journal-title":"Ann Intensive Care"},{"issue":"12","key":"2025042308422858300_R7","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1056\/NEJMoa1005372","article-title":"ACURASYS Study Investigators. Neuromuscular blockers in early acute respiratory distress syndrome","volume":"363","author":"Papazian","year":"2010","journal-title":"N Engl J Med"},{"issue":"11","key":"2025042308422858300_R8","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.1007\/s00134-020-06248-3","article-title":"ECMO for severe ARDS: systematic review and individual patient data meta-analysis","volume":"46","author":"Combes","year":"2020","journal-title":"Intensive Care Med"},{"issue":"1","key":"2025042308422858300_R9","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1053\/j.jvca.2023.10.025","article-title":"Obesity and extracorporeal membrane oxygenation (ECMO): analysis of outcomes","volume":"38","author":"Ripoll","year":"2024","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2025042308422858300_R10","doi-asserted-by":"publisher","first-page":"932","DOI":"10.7205\/MILMED-D-10-00294","article-title":"The introduction of extracorporeal membrane oxygenation to aeromedical evacuation","volume":"176(8)","author":"Allan","year":"2011","journal-title":"Mil Med"},{"issue":"11-12","key":"2025042308422858300_R11","doi-asserted-by":"publisher","first-page":"E2055","DOI":"10.1093\/milmed\/usaa215","article-title":"Evolution of the United States military Extracorporeal Membrane Oxygenation Transport team","volume":"185","author":"Read","year":"2020","journal-title":"Mil Med"},{"key":"2025042308422858300_R12","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.accpm.2019.04.006","article-title":"ARDS in patients with chest trauma: better safe than sorry","volume":"38(3)","author":"Jabaudon","year":"2019","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2025042308422858300_R13","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.826682","article-title":"Risk factors analysis of thoracic trauma complicated with acute respiratory distress syndrome and observation of curative effect of lung-protective ventilation","volume":"8","author":"Ma","year":"2022","journal-title":"Front Surg"},{"author":"Extracorporeal Life Support Organization","article-title":"General guidelines for all ECLS cases. August 2017","key":"2025042308422858300_R14"},{"key":"2025042308422858300_R15","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/j.jcrc.2018.08.003","article-title":"Obesity survival paradox in pneumonia supported with extracorporeal membrane oxygenation: analysis of the national registry","volume":"48(DEC)","author":"Cho","year":"2018","journal-title":"J Crit Care"},{"key":"2025042308422858300_R16","first-page":"22","article-title":"Bariatric patients and aeromedical retrieval","volume":"7(AUG)","author":"Lombardi","year":"2012","journal-title":"J Aust Soc Aerosp Med"},{"volume-title":"Global Air Ambulance","article-title":"Medical transport of bariatric patients","key":"2025042308422858300_R17"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/e1309\/62050114\/usaf045.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/e1309\/62050114\/usaf045.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T12:42:35Z","timestamp":1745412155000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/5-6\/e1309\/8030005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,22]]},"references-count":17,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2025,2,22]]},"published-print":{"date-parts":[[2025,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf045","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,2,22]]}}}