ABSTRACT Cardiac arrest due to severe chest trauma with thoracic aortic injury presents a significant challenge in emergency medicine. Extracorporeal cardiopulmonary resuscitation (ECPR) offers a potentially lifesaving intervention for such cases. We report a case of a 22‐year‐old male who sustained an open chest trauma with thoracic aortic injury from a stab wound, resulting in cardiac arrest. The patient was treated with ECPR combined with emergent surgical repair. Electrical impedance tomography (EIT) monitoring provided real‐time functional assessment of regional lung mechanics during the 8‐day ECMO support period. Serial chest radiographs documented improvement following bedside hematoma evacuation, with improvement in PaO 2 /FiO 2 ratio from 118 to 442.5. The patient achieved successful ECMO weaning; however, due to prolonged cardiac arrest time exceeding 30 min, neurological recovery was not achieved (GCS remained 3 T), and the family withdrew care after 2 months. Despite the unfavorable neurological outcome, this case demonstrates the technical feasibility of ECPR in severe penetrating chest trauma and provides valuable experience for managing similar cases with potentially shorter arrest times.
Gao et al. (2026) studied this question.