A 39-year-old man experienced total obstruction of a distal tracheal plastic stent by a tumor mass, preventing effective ventilation and resulting in cardiac arrest. Resuscitation by emergency bedside venoarterial extracorporeal membrane oxygenation (ECMO) permitted time to physically remove the obstructing tumor and reestablish successful ventilation and liberation from ventilatory support. We review several other reported cases of emergency ECMO to resuscitate patients with acute airway obstruction.
CardarelliMG, YoungAJ, GriffithB. Use of extracorporeal membrane oxygenation for adults in cardiac arrest (E-CPR): a meta-analysis of observational studies. ASAIO J, 2009; 55(6):581–586.
2.
WillmsDC, AtkinsPJ, DembitskyWP, JaskiBE, GockaI. Analysis of clinical trends in a program of emergent ECLS for cardiovascular collapse. ASAIO J, 1997; 43(1):65–68.
3.
DuncanBW, IbrahimAE, HraskaV, del NidoPJ, LaussenPC, WesselDL, et al. Use of rapid-deployment extracorporeal membrane oxygenation for the resuscitation of pediatric patients with heart disease after cardiac arrest. J Thorac Cardiovasc Surg, 1998; 116(2):305–309.
4.
YatacoJC, MehtaAC. Upper airway obstruction. In:RaoofS, GeorgeL, SalehA, SungA, editors. Manual of critical care. New York: McGraw Hill Medical; 2009:388–397.
5.
HigashiK, TakeshitaJ, TerasakiH, TanoueT, EsakiK, SakamotoM, et al. A case of acute airway obstruction with sharp sawdust particles, successfully treated by extracorporeal lung assist. Kokyu To Junkan, 1989; 37(3):329–333. Article in Japanese..
6.
MorneaultL, JohnstonA, PerreaultT. Management of acute airway obstruction using extracorporeal membrane oxygenation. ASAIO J, 1996; 42(4):321–323.
7.
IsaacsonG. Acute airway obstruction in the hospitalized infant: four hard lessons in the distal trachea. Ann Otol Rhinol Laryngol, 1996; 105(7):532–535.
8.
RosaPJr, JohnsonEA, BarciaPJ. The impossible airway: a plan. Chest, 1996; 109(6):1649–1650.
9.
ShiraishiT, KawaharaK, ShirakusaT, TashiroT, ImakiireT, OkabayashiK, IwasakiA. Primary tracheal fibrosarcoma in a child: a case of tracheal resection under ECMO support. Thorac Cardiovasc Surg, 1997; 45(5):252–254.
10.
StewartAS, SmytheWR, AukburgS, KaiserLR, FoxKR, BavariaJE. Severe acute extrinsic airway compression by mediastinal tumor successfully managed with extracorporeal membrane oxygenation. ASAIO J, 1998; 44(3):219–221.
11.
BelmontMJ, WaxMK, DeSouzaFN. The difficult airway: cardiopulmonary bypass: the ultimate solution. Head Neck, 1998; 20(3):266–269.
12.
BrownKL, SheflerA, CohenG, DeMunterC, PigottN, GoldmanAP. Near-fatal grape aspiration with complicating acute lung injury successfully treated with extracorporeal membrane oxygenation. Pediatr Crit Care Med, 2003; 4(2):243–245.
13.
ChaoVT, LimDW, TaoM, ThirugnanamA, KoongHN, LimCH. Tracheobronchial obstruction as a result of mediastinal mass. Asian Cardiovasc Thorac Ann, 2006; 14(2):e17–e18.
14.
IgnacioRCJr, FalconeRAJr, BrownRL. A case report of severe tracheal obstruction requiring extracorporeal membrane oxygenation. J Pediatr Surg, 2006; 41(10):E1–E4.
15.
CollarRM, TaylorJC, HogikyanND, TutuoN, OhyeRG, GreenGE. Awake extracorporeal membrane oxygenation for management of critical distal tracheal obstruction. Otolaryngol Head Neck Surg, 2010; 142(4):618–620.
16.
HollidayT, JacksonA. Emergency use of extracorporeal membrane oxygenation for a foreign body obstructing the airway. Crit Care Resusc, 2010; 12(4):273–275.
17.
HicksGL. The impossible intubation – what next?. J Cardiovasc Surg (Torino), 1986; 27(6):737–739.
18.
WeberTR, KountzmanB. Extracorporeal membrane oxygenation for nonneonatal pulmonary and multiple-organ failure. J Pediatr Surg, 1998; 33(11):1605–1609.
