Trauma Pneumonectomy: Has Survival Improved Over Two Decades?

This study examines changes in survival outcomes for patients undergoing trauma pneumonectomy over two decades (2003–2010 vs. 2011–2023) at a single Level 1 trauma center. Despite similar injury severity, patients in the second decade presented with more severe physiological derangement but experienced a notable reduction in late mortality (9% vs. 50%), coinciding with universal use of thoracic damage control (TDC) surgery and increased early application of venovenous extracorporeal membrane oxygenation (VV-ECMO). Early mortality remained high and unchanged, primarily due to hemorrhagic shock and acute right ventricular failure. The findings suggest that combining TDC and early VV-ECMO may improve survival in patients who survive the initial postoperative period, although overall mortality rates have not significantly changed.