Case reportUse of Venovenous Extracorporeal Membrane Oxygenation Under Regional Anesthesia for a High-Risk Rigid Bronchoscopy
Section snippets
Case Report
A 27-year-old man (85 kg) was referred to a tertiary academic hospital for rigid bronchoscopic extraction of 2 superimposed endotracheal prostheses located in the proximal part of the trachea. In his medical history, there was a long stay in the intensive care unit after a car accident, necessitating a prolonged intubation and a transient tracheotomy. Subsequently, the patient developed a proximal tracheal stenosis treated by laser and placement of a coated stent. Several months later, a 2nd
Discussion
The term ECMO was initially coined to describe an extracorporeal oxygenation support circuit used in adult patients presenting with acute respiratory distress syndrome (ARDS).4 A recent multicenter randomized control trial (CESAR trial) investigated the comparative effectiveness and cost-effectiveness of conventional ventilatory support versus ECMO for severe acute respiratory failure.5 Its results show that ECMO significantly reduces mortality and/or severe disability 6 months after
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Cited by (21)
Venovenous Extracorporeal Membrane Oxygenation for a Difficult Airway Situation—A Recommendation for Updating the American Society of Anesthesiologists' ‘Difficult Airway Algorithm’
2023, Journal of Cardiothoracic and Vascular AnesthesiaApplication of extracorporeal membrane oxygenation in the endoscopic treatment of severe benign airway stenosis: A case report and literature review
2021, Laparoscopic, Endoscopic, and Robotic SurgeryCitation Excerpt :In both patients, a bronchial reconstruction was successfully performed, supported by complete ECMO oxygenation.7 Several authors have reported successful tumor resections and removal of foreign bodies under ECMO oxygenation support during tracheal procedures.8,9 Among these 14 patients, VV-ECMO was used to maintain oxygenation during complex airway interventions for 9 patients (Table 1).7–16
Preemptive veno-venous ECMO support in a patient with anticipated difficult airway: A case report
2020, Respiratory Medicine Case ReportsCitation Excerpt :All 45 patients from the analyzed clinical cases were reported to survive to hospital discharge without significant complications [33]. However, very few studies reported the elective use of both forms of ECMO (VV and VA) in patients with anticipated difficult airway [24,33–46]. Indeed, a very recent study reported the perioperative use of VV ECMO in a case of severe extrinsic airway obstruction of the trachea [38].
Extracorporeal Membrane Oxygenation-Assisted Airway Management for Difficult Airways
2018, Journal of Cardiothoracic and Vascular AnesthesiaUse of venovenous extracorporeal membrane oxygenation in central airway obstruction to facilitate interventions leading to definitive airway security
2013, Journal of Critical CareCitation Excerpt :Extracorporeal membrane oxygenation (ECMO) has been used to manage cardiac and respiratory failure for more than 30 years. It has also emerged as a useful means of short-term support in hypoxic patients for nontraditional indications such as upper airway surgery [1,2], pulmonary embolism [3], and malignant airway obstruction [4]. However, there are a few reports of the use of ECMO to provide airway security in patients with an obstructed airway while their obstruction is being managed.
Perioperative Management of the Pregnant Patient with an Anterior Mediastinal Mass
2012, Anesthesiology ClinicsCitation Excerpt :Fig. 3 is a new proposed algorithm that could be used to guide the decision-making process. One example of a textbook perioperative plan for a case like this would be to institute CPB30–32 or, as some case studies have reported, extracorporeal membrane oxygenation33 before induction. Many physicians would agree that instituting CPB is conceptually simple but quite difficult to execute, especially in an emergency setting,6,13,20,34 and has little benefit in the management of these patients.