The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

Kim, Chang-Wan; Kim, Do-Hyung; Son, Bong Soo; Cho, Jeong Su; Kim, Yeong‐Dae; Hoseok, I; Ahn, Hye‐Jin

doi:10.5761/atcs.oa.15-00073

Cited by 69 publications

(46 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Within these case series, only select cases met criteria for inclusion in the review. 21 One included paper was published in Japanese, 29 and one published only as an abstract, 30 but these abstracts revealed sufficient clinical information to be included in the review. The most frequent reasons for exclusion were failing the predetermined inclusion criteria, patients \ 18 yr, and inability to obtain detailed patient information.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Results are summarized in the Table. The patients presenting with critical airway obstruction had a range of airway pathologies. These included: tracheal tumour (14 patients, 31%), 22,24,27,28,31 tracheal stenosis (nine patients, 20%), 21,22,38,39 head and neck cancer (nine patients, 20%), 23,29,40 large mediastinal mass (six patients, 13%), 47 primary lung cancer (two patients, 5%), 25,30 benign thyroid goiter (two patients, 5%), 53,54 esophageal cancer (one patient, 2%), 25 malignant melanoma (one patient, 2%), 55 and tracheal granulomas (one patient, 2%). 56 All surgeries included in this review were performed in tertiary institutions with ready access to CPB or ECMO.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review

Malpas

Hung

Gilchrist

et al. 2018

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management.Thirty-six papers were retrieved discussing the use of ECMO or cardiopulmonary bypass (CPB) for the management of critical airway obstruction. Forty-five patients underwent pre-induction of anesthesia institution of CPB or ECMO for airway obstruction. The patients presenting with critical airway obstruction had a range of airway pathologies with tracheal tumours (31%), tracheal stenosis (20%), and head and neck cancers (20%) being the most common. All cases reported a favourable patient outcome with all patients surviving to hospital discharge without significant complications.While most practitioners are familiar with the fundamental airway techniques of bag-mask ventilation, supraglottic airway use, tracheal intubation, and front-of-neck airway access for oxygenation, these techniques have limitations in managing patients with pre-existing severe airway obstruction. The use of ECMO should be considered in patients with severe (or near-complete) airway obstruction secondary to anterior neck or tracheal disease. This approach can provide essential tissue oxygenation while attempts to secure a definitive airway are carried out in a controlled environment.

show abstract

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review

Malpas

Hung

Gilchrist

et al. 2018

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Advanced tumors requiring extensive en-bloc resection have been managed with VA ECMO due to the need for vigorous retraction of the heart and great vessels. Both central and peripheral cannulation has been described (24) VV ECMO support is more often reported and is suitable for tracheal and carinal resection including carinal pneumonectomy (26)(27)(28)). An unusual case of repair of a complex tracheoesophageal fistula was reported using pumpless AV ECMO for CO 2 removal.…”

Section: Airway Surgerymentioning

confidence: 99%

Principles and indications of extracorporeal life support in general thoracic surgery

McRae¹,

Perrot²

2018

J. Thorac. Dis.

View full text Add to dashboard Cite

The role of extracorporeal life support (ECLS) has expanded rapidly over the past 15 years to become an important tool in advanced general thoracic surgery practice. Intra-operative and in some cases continued post-operative ECLS is redefining the scope of complex surgical care. ECLS encompasses a spectrum of temporary mechanical support that may remove CO 2 , oxygenate or provide hemodynamic support or a combination thereof. The most common modalities used in general thoracic surgery include extracorporeal membrane oxygenation (ECMO), interventional lung assist device (iLA ® Novalung ® , Heilbronn, Germany), and extracorporeal CO 2 removal (ECCO 2 R). The ECMO and Novalung ® devices can be used in different modes for the short term or long-term support depending on the situation. In this review, the principles and current applications of ECLS in general thoracic surgery are presented.

show abstract

“…Extracorporeal membrane oxygenation has been used, but this adds complexity, expense and is not without risk. It is therefore reserved for high-risk patients [4,5].…”

Section: Introductionmentioning

confidence: 99%

High‐flow apnoeic oxygenation delivered by LMA or tracheal tube for tracheal resection and reconstruction surgery

Egan¹,

Redmond

2018

Anaesthesia Cases

View full text Add to dashboard Cite

Airway management for tracheal resection and reconstruction can be challenging. 'LET Flow' is a novel technique using a high-flow oxygen delivery device attached directly to a laryngeal mask or tracheal tube that may provide apnoeic oxygenation during surgery on an open trachea.We report a case where a high-flow oxygen device, AIRVO™ 2 (Fisher & Paykel Healthcare, Aukland, New Zealand), was attached to a size three laryngeal mask airway and 100% oxygen at a flow-rate of 40 l.min -1 delivered across an open trachea. This permitted 42 minutes of uninterrupted surgery in an apnoeic female patient with subglottic tracheal stenosis. Oxygen saturations remained above 96% during the apnoeic period and arterial blood gas parameters within acceptable limits. To avoid possible barotrauma or volutrauma as complete tracheal closure approached, flow was reduced to 10 l.min -1 followed by laryngeal mask cuff deflation. Mechanical ventilation recommenced at tracheal closure. 'LET Flow' provided optimal surgical conditions by removing an airway device from the operative field. No urgent interruption of surgery or rescue mechanical ventilation was required.

show abstract

The Feasibility of Extracorporeal Membrane Oxygenation in the Variant Airway Problems

Cited by 69 publications

References 11 publications

The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review

The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review

Principles and indications of extracorporeal life support in general thoracic surgery

High‐flow apnoeic oxygenation delivered by LMA or tracheal tube for tracheal resection and reconstruction surgery

Contact Info

Product

Resources

About