{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:46:05Z","timestamp":1791834365219,"version":"4.3.4"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence, clinical characteristics, complications, and outcomes for extracorporeal membrane oxygenation (ECMO) in penetrating trauma cases are mostly unknown. The purpose of this study was to evaluate the concept that ECMO could be a safe and effective therapy after severe penetrating injury at a single high-volume center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case series of all penetrating trauma patients supported with ECMO at a single Level I trauma center between January 2022 and June 2025. Data collected included demographics, injury patterns, ECMO indications and cannulation details, anticoagulation management, operative interventions performed on ECMO, bleeding and thrombotic complications, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight patients were supported with veno-venous ECMO, all male, with a median age of 36\u00a0years and a median Injury Severity Score of 20. Injury mechanisms included six gunshot wounds and two stab wounds, with a median PaO2\/FiO2 ratio of 71 at ECMO consultation. Anticoagulation was individualized, with initiation delayed a median of 4\u00a0days after cannulation, and one patient received no anticoagulation throughout their ECMO course. Four patients underwent major operative procedures while on ECMO. Three patients had manageable bleeding complications, and three had thrombotic complications not associated with anticoagulation interruption. Overall survival to hospital discharge was 75% (6\/8 patients).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case series demonstrates basic proof of concept that ECMO can be safely implemented in carefully selected penetrating trauma patients. Individualized anticoagulation strategies and concurrent operative management were feasible with manageable complications. Further multicenter studies are needed to define optimal patient selection and anticoagulation practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261496001","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:56:44Z","timestamp":1791471404000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Veno-Venous ECMO after Penetrating Trauma: A Viable Option With Individualized Anticoagulation"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5592-9302","authenticated-orcid":false,"given":"Talia R.","family":"Arcieri","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Reyes","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshat","family":"Sanan","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avery M.","family":"Hebert","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7650-4294","authenticated-orcid":false,"given":"Joyce I.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis R.","family":"Pizano","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Namias","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Pipkin","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G.","family":"Proctor","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3935-1276","authenticated-orcid":false,"given":"Brandon M.","family":"Parker","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"7","key":"e_1_3_3_2_2","first-page":"E166","article-title":"Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology","volume":"7","author":"Makdisi G","year":"2015","unstructured":"Makdisi G, Wang IW. Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015;7(7):E166-E176.","journal-title":"J Thorac Dis"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-024-02862-0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000213"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta14350"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211011112"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00331-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-024-02557-6"},{"key":"e_1_3_3_9_2","first-page":"1070830","article-title":"Two venovenous extracorporeal membrane oxygenation for one gunshot","volume":"2022","author":"Pot L","year":"2022","unstructured":"Pot L, Porto A, Le Saux A, et al. Two venovenous extracorporeal membrane oxygenation for one gunshot. Case Rep Crit Care. 2022;2022:1070830.","journal-title":"Case Rep Crit Care"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231161082"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001068"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003134820956360"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.03.029"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231180917"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.08.076"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.21037\/acr-23-76"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480907501224"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16955"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.06.008"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1552037"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.72194"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261496001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261496001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261496001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:03:04Z","timestamp":1791831784000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261496001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":20,"alternative-id":["10.1177\/00031348261496001"],"URL":"https:\/\/doi.org\/10.1177\/00031348261496001","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]},"article-number":"00031348261496001"}}