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Journal of Artificial Organs

, Volume 21, Issue 4, pp 479–481 | Cite as

Venovenous extracorporeal membrane oxygenation for the management of critical airway stenosis

  • Yu Yamada
  • Toshihiro Ohata
  • Mutsunori Kitahara
  • Hisakazu Kohata
  • Junji Kumasawa
  • Michihiko Kohno
Case Report Artificial Lung / ECMO
  • 39 Downloads

Abstract

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.

Keywords

VV-ECMO Critical airway stenosis 

References

  1. 1.
    Abrams D, Brodie D. Novel uses of extracorporeal membrane oxygenation in adults. Clin Chest Med. 2015;36:373–84.CrossRefGoogle Scholar
  2. 2.
    Combes A, Brodie D, Barlett R, et al. Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients. Am J Respir Crit Care Med. 2014;190:488–96.CrossRefGoogle Scholar
  3. 3.
    Delnoij TS, Driessen R, Sharma AS, et al. Venovenous extracorporeal membrane oxygenation in intractable pulmonary insufficiency: practical issues and future directions. Biomed Res Int 2016; 2016:967464.CrossRefGoogle Scholar
  4. 4.
    Hoetzenecker K, Klepetko W, Keshavjee S, Cypel M. Extracorporeal support in airway surgery. J Thorac Dis. 2017;9:2108–17.CrossRefGoogle Scholar
  5. 5.
    Finlayson GN, Brodsky JB. Anesthetic considerations for airway stenting in adult patients. Anesthesiol Clin. 2008;26:281–91.CrossRefGoogle Scholar
  6. 6.
    Pathak V, Welsby I, Mahmood K, et al. Ventilations and anesthetic approaches for rigid bronchoscopy. Ann Am Thorac Soc. 2014;11:628–34.CrossRefGoogle Scholar
  7. 7.
    Abrams D, Bacchetta M, Brodie D. Recirculation in venovenous extracorporeal oxygenation. ASAIO J. 2015;61:115–21.CrossRefGoogle Scholar
  8. 8.
    Javidfar J, Brodie D, Wang D, et al. Use of bicaval dual-lumen catheter for adult venovenous extracorporeal membrane oxygenation. Ann Thorac Surg. 2011;91:1763–9.CrossRefGoogle Scholar
  9. 9.
    Takayama H, Naka Y, Kodali SK, et al. A novel approach to percutaneous right-ventricular mechanical support. Eur J Cardiothorac Surg. 2012;41:423–6.CrossRefGoogle Scholar

Copyright information

© The Japanese Society for Artificial Organs 2018

Authors and Affiliations

  • Yu Yamada
    • 1
  • Toshihiro Ohata
    • 1
  • Mutsunori Kitahara
    • 1
  • Hisakazu Kohata
    • 2
  • Junji Kumasawa
    • 2
  • Michihiko Kohno
    • 2
  1. 1.Department of Cardiovascular SurgerySakai City Medical CenterSakaiJapan
  2. 2.Department of Critical Care MedicineSakai City Medical CenterSakaiJapan

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