Veno-venous ECMO during surgical repair of tracheal perforation: A case report

Filippo Antonacci, Chiara De Tisi, Ilaria Donadoni, Marco Maurelli, Giorgio Iotti, Fabio Silvio Taccone, Giulio Orlandoni, Carlo Pellegrini, Mirko Belliato

Research output: Contribution to journalArticle

Abstract

Introduction Extracorporeal membrane oxygenation (ECMO) is used extensively in cardiothoracic surgery both for hemodynamic and respiratory support. It has proven to be a valuable tool to maintain adequate oxygenation during tracheal surgery. Airway lesion may be an indication for veno-venous ECMO both in case of conservative management and in case of surgical repair. Here we report the case of a patient with a iatrogenic tracheal injury, successfully operated with the support of veno-venous extracorporeal oxygenation. Presentation of case A 39-year-old female underwent an elective laparoscopic adhesiolysis. At the end of the procedure, the patient had developed subcutaneous emphysema. A CT-scan showed mediastinal and subcutaneous emphysema and left pneumothorax with a laceration of the membranous portion of the middle third of the trachea. A left pleural drain was inserted and a bronchoscopy showed a 2-cm long tear of the membranous portion in the middle third of the trachea. Veno-venous ECMO was established and surgical repair of the tracheal lesion was performed. Post-operative recovery was uneventful and the patient was discharged on 8th postoperative day. Discussion The use of Veno-venous ECMO allowed a safe intubation with optimal oxygenation. A selective intubation with a small tube was performed to prevent further tracheal injury and allow an adequate surgical space for tracheal repair. Conclusion The use of ECMO support represents a safe and effective way to manage patients with ITI when surgical repair with minimally invasive ventilation is needed. Since this is a case report larger studies are needed to validate the technique.

Original languageEnglish
Pages (from-to)64-66
Number of pages3
JournalInternational Journal of Surgery Case Reports
Volume42
DOIs
Publication statusPublished - Jan 1 2018
Externally publishedYes

Keywords

  • Case report
  • ECMO
  • Tracheal perforation

ASJC Scopus subject areas

  • Surgery

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