Deng Li, Wang Baichun, Wang Yan, Xiao Lifeng, Liu Hongyu
Department of Cardiac Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150006, China.
Int J Pediatr Otorhinolaryngol. 2017 Mar;94:82-86. doi: 10.1016/j.ijporl.2017.01.011. Epub 2017 Jan 12.
We present a case in which extracorporeal life support treatment of a 6-year-old girl asphyxiated by aspiration of an elliptic plastic ball is described. The attempts for extraction of the foreign body by conventional bronchoscopy under critically ill conditions had failed. Thus, a skin incision was made in the midline, and an emergency open-chest cardiopulmonary bypass (CPB) with aortic, superior vena cava and inferior vena cava cannulation was performed for circulatory support. Following tracheal extubation, a video-assisted rigid bronchoscope was inserted to clear the airway and remove the foreign body. The CPB lasted for 68 min, and the endotracheal tube was pulled out 6 h after the surgery. On the 10th day, the patient was discharged and followed up for 3 months when no neurological symptoms or other complications were documented. The removal of the aspirated bronchial foreign body under extracorporeal life support has been rarely reported. Here, we review the indication, cannulation method, support mode, surgical procedure, and patient outcome in the 8 papers retrieved from the PubMed database and compare their clinical characteristics with those of our case to justify the safe and effective use of CPB for critically ill patients with bronchial foreign body aspiration.
我们报告了一例6岁女孩因误吸椭圆形塑料球窒息后接受体外生命支持治疗的病例。在危重症情况下，试图通过传统支气管镜取出异物的尝试失败。因此，在中线做皮肤切口，进行紧急开胸体外循环（CPB），通过主动脉、上腔静脉和下腔静脉插管进行循环支持。气管插管拔除后，插入电视辅助硬质支气管镜清理气道并取出异物。CPB持续68分钟，术后6小时拔出气管插管。第10天，患者出院，随访3个月，未发现神经症状或其他并发症。在体外生命支持下取出误吸的支气管异物的报道很少。在此，我们回顾了从PubMed数据库检索到的8篇论文中的适应证、插管方法、支持模式、手术过程和患者结局，并将其临床特征与我们病例的特征进行比较，以证明CPB在支气管异物误吸危重症患者中的安全有效应用。
