CLINICAL APPLICATION OF ECMO TO SUPPORT ENDOTRACHEAL INTERVENTION FOR TWO PATIENTS WITH MALIGNANT OCCLUSION OF CARINA

• Published in: Jinko Zoki Vol. 26; no. 3; pp. 664 - 667
• Main Authors: SUGANO, T., TANABE, S., MAESHIRO, T., MATSUNAGA, H., OHKOHCHI, Y., TANAKA, T., SUNAMORI, M., YAMADA, T.
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR ARTIFICIAL ORGANS 1997
• Subjects: endotracheal intervention; large airway obstruction; venoarterial ECMO; venovenous ECMO
• ISSN: 0300-0818; 1883-6097
• DOI: 10.11392/jsao1972.26.664

We experienced two cases of endotracheal intervention under extracorporeal membrane oxygenation (ECMO). We could not manage these patients with conventional endotracheal anesthesia because of critical large airway obstruction. These procedures released the patients from dyspnea. Case 1 was a 65-years-old male. He had undergone left lower lobectomy for epidermoid cell carcinoma of lung before 6 months. The recurrent cancer occupied the carina and the right main bronchus; the obstruction occurred. We were successful in YAG laser therapy of this case under venovenous ECMO (v-v ECMO). Blood had been completely mixed before aorta, blood gas analysis from the peripheral artery represented average O2 and CO2 condition. Case 2 was a 65-years-old female. She had undergone extended radical hysterectomy for the right ovarian cancer before two years. The ovarian adenocarcinoma had spread to the mediastinal lymphnodes and lung; severe obstruction of the canna and the left main bronchus occurred. We inserted tracheobronchial stent under venoarterial ECMO (v-a ECMO). These two cases showed effectiveness and safety of ECMO; it secured gas exchange during long apnea for endotracheal approach. In case without cardiac disorder, v-v ECMO is easier to estimate its effectiveness in viva and simpler to set up and to remove than v-a ECMO.