Introduction:
The indications for extracorporeal membrane oxygenation (ECMO) have
expanded as the technology has become an integral component of
extracorporeal life support (ECLS). Drs. Gibbon, Rashkind, and Dorson
described the use of ECMO in the 1950s and 1960s for cardio-pulmonary
failure in neonates and subsequently expanded to the adult
population1.
In addition to standard indications in patients with parenchymal lung
failure, ECMO has been used to achieve stable oxygenation/ventilation in
the peri- and intra-operative period prior to re-establishment of airway
patency in patients with critical tracheal stenosis secondary to
tracheal tumors or mediastinal mass/neoplasms causing extrinsic airway
compression2. Critical tracheal stenosis defined as
greater than 75% narrowing of the airway lumen that is often associated
with extreme respiratory distress and difficult
intubation3. Although not novel, the use of
intra-operative ECMO in cases of critical tracheal stenosis has not
frequently been described. We present a case of a large right
paratracheal mass that significantly compressed the intrathoracic
trachea; VV ECMO was instituted to allow safe endotracheal intubation
and lung isolation to resect the lesion and relieve the tracheal
stenosis. Institutional Review Board and informed consent waiver are
included in our supplementary files.