Pre-emptive extracorporeal membrane oxygenation to support endobronchial stenting for severe airway obstruction

• Published in: European journal of cardio-thoracic surgery Vol. 59; no. 6; pp. 1345 - 1346
• Main Authors: Ni Fhlatharta, Meadhbh, Khan, Asad, Carton, Edmund, Redmond, Karen C
• Format: Journal Article
• Language: English
• Published: Oxford University Press 14.06.2021
• Subjects: ECMO; Airway obstruction; Endobronchial stenting
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezaa425

Abstract Tracheobronchial stent insertion is a common palliative intervention for the management of dynamic airway collapse due to severe tracheobronchomalacia or tracheal compression due to mass effect [1]. Airway stents are usually placed bronchoscopically with or without fluoroscopy. In more complex cases, airway stents are placed using a rigid bronchoscope under general anaesthesia with conventional or jet ventilation. In patients where advancement of a rigid bronchoscope into the distal airway or ventilation through a rigid bronchoscope may be difficult, pre-emptive awake veno-venous extracorporeal membrane oxygenation should be considered. This report is the first publication to describe a novel technique in a series of patients being treated for critical airway obstruction who would otherwise be at risk of respiratory arrest at the induction of anaesthesia.