Extracorporeal membrane oxygenation as a bridge to definitive tracheal reconstruction in neonates

Kunisaki, Shaun M.; Fauza, Dario O.; Craig, Nancy; Jennings, Russell W.

doi:10.1016/j.jpedsurg.2007.12.014

Cited by 25 publications

(12 citation statements)

References 20 publications

(24 reference statements)

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“…[4][5][6] ECMO use is increasing in cases requiring complicated trachea surgery, such as severe tracheal stenosis (due to intrinsic or extrinsic problems), carinal resection and reconstruction, congenital trachea surgery and long-segment trachea tumor. [7][8][9] ECMO confers superior visualization at the surgical site compared with mechanical ventilation and does not require endotracheal tubes or aggressive ventilation techniques. Several studies have reported that ECMO reduces the risks of surgery in pediatric patients, allowing for more precise airway reconstruction.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

Kim

Son

et al. 2015

ATCS

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Section: Discussionmentioning

confidence: 99%

The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

Kim

Son

et al. 2015

ATCS

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“…Conventional cardiopulmonary bypass (CPB) is an alternative to VV-ECMO but it results in coagulation disorders and a greater systemic inflammatory response compared with ECMO. In addition it is not intended for long term support, whereas ECMO can be continued for long periods without major complications [8]. ECMO was first used by Bartlett in the 1970's [9,10] and is now in widespread use in both children and adults.…”

Section: Discussionmentioning

confidence: 99%

Use of Extracorporeal Membrane Oxygenation (ECMO) in the management of an obstructed airway

Ren

2014

Anaesthesia Cases

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We present a case in which veno-venous extracorporeal membrane oxygenation (VV-ECMO) was implemented, along with general anaesthesia, for resection of a large endotracheal tumour obstructing the airway just proximal to the carina. To control oxygenation prompt implementation of ECMO was instituted under sedation before induction of general anaesthesia. The advantage of ECMO was demonstrated in a challenging situation where mechanical ventilation of the lungs was impossible. Airway obstruction at the level of the carina poses a great challenge to every anaesthetist. There are few case reports on the successful use of ECMO during procedures involving the difficult airway [1][2][3]. As far as we are aware this is hte first case report describing the use of ECMO to facilitate bronchoscopic resection of a tumour at the level of the carina causing near complete airway obstruction.

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“…One of their patients with long-segment congenital tracheal stenosis had a tracheal dehiscence and died from mediastinitis. Kunisaki et al 19 and Huang et al 20 used ECMO as a bridge to airway surgery. Clearly, ECMO management of tracheal stenosis is not new, 21 and the Extracorporeal Life Support Organization's registry data from 2007 to 2010 includes 21 patients who underwent ECMO for tracheal stenosis during that period.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty

et al. 2011

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Long-segment congenital tracheal stenosis is characterized by complete tracheal rings. Surgery is required during infancy to optimize outcomes, and the post-surgery complications include mucus plugging, airway trauma, dehiscence at the surgery site, and death. We report a 5-week-old patient who developed a tracheal-wall dehiscence after a slide tracheoplasty. To safeguard against further dehiscence and to protect her one functional lung, we used extracorporeal membrane oxygenation (ECMO). After she was stabilized on veno-arterial ECMO we extubated and continued ECMO for 5 days. On postoperative day 14 we removed the ECMO and transitioned her to high-frequency oscillatory ventilation, and performed slow lung-recruitment maneuvers every 2 hours. This strategy of ECMO with extubation, then high-frequency oscillatory ventilation is a useful rescue therapy in patients with postoperative tracheal dehiscence.

show abstract

Extracorporeal membrane oxygenation as a bridge to definitive tracheal reconstruction in neonates

Cited by 25 publications

References 20 publications

The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

Use of Extracorporeal Membrane Oxygenation (ECMO) in the management of an obstructed airway

Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty

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