Successful difficult airway management with emergent venovenous extracorporeal membrane oxygenation in a patient with severe tracheal deformity: a case report

摘要

A man was transferred to our hospital due to worsening dyspnea. Intubation could not be carried out because he had severe tracheal deformity due to cervical‐thoracic kyphosis secondary to vertebral tuberculosis. Therefore, we carried out a surgical tracheostomy under venovenous extracorporeal membrane oxygenation. Background Difficult airway management is occasionally encountered in the emergency department, and recent studies suggest that extracorporeal membrane oxygenation can be useful in these cases. Case Presentation A 74‐year‐old man was transferred to our hospital due to worsening dyspnea. On arrival, it was found that he was in respiratory distress and was comatose. Arterial blood gas analysis showed severe hypercapnia and respiratory acidosis. Intubation could not be done because he had severe tracheal deformity due to cervical‐thoracic kyphosis secondary to vertebral tuberculosis. Therefore, we carried out surgical tracheostomy under venovenous extracorporeal membrane oxygenation. The patient’s oxygenation gradually improved, and extracorporeal membrane oxygenation was withdrawn on day 8. He was transferred to another hospital on day 46 and suffered no neurological deficits. Conclusion Severe tracheal deformity can result in a difficult airway. Extracorporeal membrane oxygenation is an effective life‐saving approach in cases of difficult airway management due to severe tracheal deformity.