Extracorporeal membrane oxygenation resuscitation for traumatic brain injury after decompressive craniotomy

Acute cardiopulmonary failure in patients with increased intracranial pressure is a significant management challenge to physicians. We report on a 21-year-old patient with traumatic brain injury who developed intractable hypoxemia and hypotension after undergoing a decompressive craniotomy. Venoarterial extracorporeal membrane oxygenation was initiated to resuscitate the patient. Extracorporeal membrane oxygenation is considered contraindicated in patients with intracranial bleeding because systemic heparin is needed during the support of extracorporeal membrane oxygenation. We describe our successful experience in tackling this dilemma.