Use of venovenous extracorporeal membrane oxygenation for resection of a large paratracheal mass causing critical tracheal stenosis: A case report

Kodia, Karishma; Liu, Yuda; Ghodsizad, Ali; Turner, Darren; Briski, Laurence M; Nguyen, Dao M.

doi:10.1111/jocs.15207

Cited by 4 publications

(3 citation statements)

References 9 publications

(4 reference statements)

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“…ECLS in V-A configuration is used as a rescue management of anterior mediastinal masses with extrinsic compression on the airways and mediastinal vessels as well as during an emergent peri-arrest setting (17)(18)(19)(20).…”

Section: Mediastinal Massmentioning

confidence: 99%

Extracorporeal life support in thoracic emergencies—a narrative review of current evidence

Willers¹,

Mariani²,

Maessen³

et al. 2023

J Thorac Dis

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Background and Objective: Resuscitative therapies for respiratory and cardiac failure are lifesaving and extended by using extracorporeal life support (ECLS) as mechanical circulatory support (MSC). This review informs the debate to identify the life-threatening thoracic emergencies in which patients may be cannulated for ECLS support.Methods: An advanced search was performed in PubMed, Embase, Google Scholar, and references query, assessed in June 2022, identified 761 records. Among them, 74 publications in English were included in the current narrative review.Key Content and Findings: ECLS is an additional tool for organ support in life-threatening thoracic emergencies. It provides bridging to recovery or to decision about destination as definitive therapy, intervention, or surgery. Non-traumatic emergencies include mediastinal mass, acute lung injury (ALI), aspiration, embolisms, acute and chronic heart failure. However, based on the current evidence, trauma, and especially blunt thoracic trauma, is one of the main indications for ECLS use in thoracic emergencies, among others in chest wall fractures, blunt and penetrating lung injuries. ECLS use is always individualized to patient's needs, injury pattern and kind of organ failure, circulatory arrest inclusive, depending on if respiratory or cardiac and circulatory support is needed. Further, ECLS offers the possibility for fast volume resuscitation and rewarming, thus preventing the lethal of trauma: hypothermia, hypoperfusion and acidosis. Anticoagulation may be omitted for some hours or days. Interdisciplinary cooperation between the intensivists, surgeons, anesthesiologists, emergency medical services, an appropriately organized and trained staff, equipment resources and logistical planning are essential for successful outcomes.Conclusions: ECLS use in selected life-threatening thoracic emergencies is increasing. The summarized findings appeal to policymakers, and we hope that our summary of recommendations may impact clinical practice and research.

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Section: Mediastinal Massmentioning

confidence: 99%

Extracorporeal life support in thoracic emergencies—a narrative review of current evidence

Willers¹,

Mariani²,

Maessen³

et al. 2023

J Thorac Dis

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“…The procedure was aborted, however, as dense material suggestive of blood clot was encountered by the IR team and there was little free fluid that was able to be drained. Given the significant tracheal compression and risk of difficult intubation, the surgical team coordinated with the extra-corporeal membrane oxygenation ( ECMO) team to electively place the patient on veno-venous (VV)-EMCO prior to intubation as previously described [ 4 ]. Bilateral femoral veins were cannulated with 23F cannula with VV-ECMO flow initiated at 4 L/min.…”

Section: Case Presentationmentioning

confidence: 99%

Middle mediastinal cavernous hemangioma: a case report of clinical, pathologic and radiologic features

Turner

Nwatu

Kodia

et al. 2022

Journal of Surgical Case Reports

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Benign vascular tumors of the mediastinum are rare, representing only 0.5% of all mediastinal masses. Given their rare presentation, they are infrequently considered in the workup of a middle mediastinal mass. We present a unique case describing the clinical, imaging and pathologic characteristics of a middle mediastinal cavernous hemangioma which was initially misdiagnosed as a bronchogenic cyst and ultimately required surgical resection with the use of veno-venous extracorporeal membrane oxygenation.

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“…Thus, respiratory distress and even failure can occur depending on the size and location of the aneurysm. If endotracheal intubation is not possible due to the anatomical location of such aneurysms, ECMO may be required to provide adequate oxygenation 26,27 . However, ECMO is associated with additional operative risks, which may be a barrier to its implementation [28][29][30][31] .…”

Section: Introductionmentioning

confidence: 99%

Use of veno-venous extracorporeal membrane oxygenation for stabilization prior to redo sternotomy for aortic pseudoaneurysm repair

Lee,

Larson,

Chinedozi

et al. 2023

gcsp

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Background: Aortic pseudoaneurysms are particularly dangerous because of the risk of rupture and compression of mediastinal structures, including the trachea, and resultant respiratory distress. If respiratory distress progresses to respiratory failure, extracorporeal membrane oxygenation may be used to provide oxygenation prior to or during pseudoaneurysm repair. Case presentation: A 62-year-old male with a history of emergent aortic ascending and arch replacement for Stanford Type A dissection 10 months prior presented to his primary care physician with dyspnea. Chest radiography revealed a widened mediastinum, and subsequent computed tomography angiogram revealed a pseudoaneurysm at the distal suture line of the aortic arch replacement. Due to the location of the pseudoaneurysm, the patient’s trachea was compressed, and he was emergently placed on veno-venous (VV) extracorporeal membrane oxygenation (ECMO) following unsuccessful intubation for respiratory distress. Two days later, the patient underwent a redo sternotomy and repair of a 2-3 mm defect in the anterior aspect of the distal suture line of the prior aortic arch replacement. The patient progressed well and was discharged on postoperative day 13. What we learned: Using a combination of peripheral bypass, hypothermic circulatory arrest, delayed closure, and respiratory support, this case demonstrates how even complex patients can be successfully treated with multiple strategies.

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Use of venovenous extracorporeal membrane oxygenation for resection of a large paratracheal mass causing critical tracheal stenosis: A case report

Cited by 4 publications

References 9 publications

Extracorporeal life support in thoracic emergencies—a narrative review of current evidence

Extracorporeal life support in thoracic emergencies—a narrative review of current evidence

Middle mediastinal cavernous hemangioma: a case report of clinical, pathologic and radiologic features

Use of veno-venous extracorporeal membrane oxygenation for stabilization prior to redo sternotomy for aortic pseudoaneurysm repair

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