The American College of Surgeons Committee on Trauma requires that all verified level I trauma centers have cardiopulmonary bypass capabilities (CPB) immediately available. The literature to support the use of CPB in trauma patients has largely been limited to case series from busy trauma centers and multiple case reports. The division of Trauma Surgery at Tufts Medical Center recently published a retrospective 6-year review using the Research Data Set of the National Trauma Data Bank (NTDB) to determine the outcomes of patients with cardiothoracic injuries who were managed with cardiopulmonary bypass. In our review, we found that patients who underwent CPB surgery had higher rates of complications, however had statistically significant lower rate of in-hospital mortality. Unfortunately, inherent limitations of the NTDB did not allow us to characterize the CPB patients in depth - we could not identify the exact indications and timing for the CPB utilization. Additionally, from our review of the NTDB, we have found CPB is infrequently used. Given its infrequent use, we are now conducting a multicenter retrospective study to further describe the use and outcomes of cardiopulmonary bypass in traumatic injuries, with the hope of further demonstrating the survival benefit of this tool and further defining the indications of its use.