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European Journal of Pediatrics

, Volume 166, Issue 11, pp 1129–1133 | Cite as

Perioperative extracorporeal membrane oxygenation support for critical pediatric airway surgery

  • Shu-Chien Huang
  • En-Ting Wu
  • Nai-Hsin Chi
  • Shuenn-Nan Chiu
  • Pei-Ming Huang
  • Yih-Sharng Chen
  • Yung-Chie Lee
  • Wen-Je KoEmail author
Original Paper

Abstract

Extracorporeal membrane oxygenation (ECMO) has been used for cardiopulmonary support in neonates, infants, and adults. We report the application of ECMO for critical airway surgery when mechanical ventilation cannot provide adequate gas exchange. Three pediatric patients underwent emergency ECMO establishment because of hypercapnia that could not be managed by conventional mechanical ventilation. The pathology included: (1) left pulmonary artery sling with long-segment tracheal stenosis; (2) absence of the right intermediate bronchus and abnormal origin of the right lower bronchus arising from the left main bronchus; (3) right-lung agenesis with long-segment tracheobronchial stenosis. Venoarterial ECMO was established. Before ECMO, the arterial pH values were 7.28, 7.0, and 7.08, and the PaCO2 values were 111.8, 112.0, and 208.7 mmHg for each patient, respectively. After ECMO support, respiratory acidosis was reversed. The patients then underwent surgical intervention. The surgical procedures included: (1) slide tracheoplasty and reimplantation of the left pulmonary artery; (2) resection of the stenotic tracheal segment and reconstruction of the bronchial tree; (3) tracheal dilatation and stent implantation. The ECMO durations were 11, 5, and 16 h, respectively. All patients were successfully weaned off ECMO without complications. In conclusion, ECMO provided adequate ventilation support for patients undergoing critical tracheobronchial reconstruction when conventional mechanical ventilation could not maintain adequate gas exchange.

Keywords

Extracorporeal membrane oxygenation (ECMO) Pediatric airway Tracheal stenosis 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Shu-Chien Huang
    • 1
    • 2
  • En-Ting Wu
    • 3
  • Nai-Hsin Chi
    • 1
  • Shuenn-Nan Chiu
    • 3
  • Pei-Ming Huang
    • 1
    • 2
  • Yih-Sharng Chen
    • 1
  • Yung-Chie Lee
    • 1
  • Wen-Je Ko
    • 1
    Email author
  1. 1.Department of SurgeryNational Taiwan University HospitalTaipeiTaiwan
  2. 2.Departments of TraumatologyNational Taiwan University HospitalTaipeiTaiwan
  3. 3.Department of PediatricsNational Taiwan University HospitalTaipeiTaiwan

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