Venovenous extracorporeal membrane oxygenation for the management of critical airway stenosis

• DOI: 10.1007/s10047-018-1070-1
• Publication Date: 2018-10-05T03:42:43Z
• Authors: Yu Yamada; Toshihiro Ohata; Mutsunori Kitahara; Hisakazu Kohata; Junji Kumasawa; Michihiko Kohno
• Keywords: Disease Management; Vena Cava, Inferior; 3. Good health; Airway Obstruction; 03 medical and health sciences; Extracorporeal Membrane Oxygenation; 0302 clinical medicine; Humans; Female; Respiratory Insufficiency; Tomography, X-Ray Computed; Aged

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is used not only support gas transfer of patients suffering from respiratory failure, but also to manage hypoxic patients with critical airway obstruction during various procedures. We present a case in which we electively used VV-ECMO to facilitate tube placement and tracheal biopsy in a 67-year-old female with critical tracheal stenosis. The patient was transferred to our hospital for a surgical treatment after emergent tracheostomy for postoperative management of cerebral hemorrhage in right putamen. Her trachea was severely stenotic and just enough for a 5.5 mm tracheostomy tube. Removal of tracheostomy tube, tracheal wall biopsy and intra-tracheal tube placement were successfully performed under VV-ECMO support, drainage from inferior vena cava returned into the right ventricle (RV). RV perfusion was a very useful and effective method in VV-ECMO system, although some careful wire management was needed under fluoroscopic guidance.