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首次在体外膜肺氧合支持下成功进行双侧主支气管横断的外科重建手术。

First Successful Surgical Reconstruction of Bilateral Transected Main Bronchi With Extracorporeal Membrane Oxygenation Support.

作者信息

Biancosino Christian, Krüger Marcus, Kühn Christian, Zinne Norman, Wilhelmi Michaela, Zeckey Christian, Krettek Christian, Gathen Martin

机构信息

Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

出版信息

Ann Thorac Surg. 2016 Aug;102(2):e135-7. doi: 10.1016/j.athoracsur.2016.01.009.

Abstract

Complex tracheobronchial injuries, especially if both main bronchi are involved, are life threatening and their diagnosis and successful treatment concerning short-term as well as long-term results are most challenging. This is the first report on a successful reconstruction of a complex bilateral bronchial injury under extracorporeal membrane oxygenation (ECMO) support. We present the course from prehospital treatment, establishment of ECMO in the emergency room to initial bronchoscopy, operative reconstruction, and intensive care therapy. Under these special circumstances ECMO provided a stable respiratory situation not only preoperatively but also intraoperatively without aggravating a compensated bronchial situation under aggressive ventilation.

摘要

复杂的气管支气管损伤,尤其是双侧主支气管均受累时,会危及生命,其诊断以及涉及短期和长期结果的成功治疗极具挑战性。这是关于在体外膜肺氧合(ECMO)支持下成功重建复杂双侧支气管损伤的首例报告。我们展示了从院前治疗、在急诊室建立ECMO到初始支气管镜检查、手术重建以及重症监护治疗的过程。在这些特殊情况下,ECMO不仅在术前而且在术中都提供了稳定的呼吸状况,而不会在积极通气的情况下加重已代偿的支气管状况。

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