Use of venovenous extracorporeal membrane oxygenation under regional anesthesia for a high-risk rigid bronchoscopy

摘要

THERE ARE NUMEROUS indications for stent placement in the central respiratory tract. The mobilization or removal of such stents using a rigid bronchoscope may expose patients to potentially severe respiratory complications. Recently, Chen reported the use of venoarterial extracorporeal membrane oxygenation (ECMO) during withdrawal of a stent covering the lower part of the trachea and the proximal part of the left mainstem bronchus. The first attempt resulted in almost complete obstruction of the trachea requiring resuscitation maneuvers. After conducting a thorough neurologic assessment of the patient, a 2nd attempt was performed on the following day. In order to ensure adequate oxygenation, the patient was put on venoarterial ECMO support under general anesthesia. The use of venovenous (VV) ECMO support set up under local anesthesia before the administration of general anesthesia in order to prevent oxygenation impairment because of the complexity of managing the airway or as a result of surgical intervention is reported.