Pre-emptive veno-venous ECMO in advanced tracheal malignancy prior to tracheal stenting

• Published in: BMJ case reports Vol. 14; no. 8; p. e243596
• Main Authors: Siddiqi, Mohammad Salman, Al Kindi, Adil H, Mandisha, Ahmed Fahmy, Al Sukaiti, Rashid
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 17.08.2021; BMJ Publishing Group
• Subjects: Airway management; Airway Obstruction - etiology; Airway Obstruction - therapy; Biopsy; Bronchoscopy; Cancer; Case Report; Case reports; Extracorporeal Membrane Oxygenation; Female; Head & neck cancer; Humans; Middle Aged; Patients; Stents; Trachea - diagnostic imaging; Trachea - surgery; Tracheal Neoplasms - complications; Tracheal Neoplasms - surgery; head and neck cancer; cancer intervention; radiology; surgical oncology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2021-243596

Extracorporeal membrane oxygenation (ECMO) is helpful in providing ventilatory support when other conventional methods of ventilation fail. We report a case of successful management of advanced tracheal malignancy with impeding airway obstruction where veno-venous ECMO (VV-ECMO) was instituted prior to performing critical endotracheal procedure. After securing the VV-ECMO through right jugular vein and left femoral vein under local anaesthesia, the tracheal stent placement was conducted under flexible bronchoscope and fluoroscope control. Oxygenation and carbon dioxide levels were maintained by the ECMO. VV-ECMO is a useful adjunct in the management of subglottic difficult airway obstruction due to complex tracheal pathology where conventional ventilation may not be possible or adequate.