Nokes Brandon T, Vaszar Laszlo, Jahanyar Jama, Swanson Karen L
Departments of Internal Medicine.
Division of Pulmonary Medicine, Mayo Clinic, Phoenix, AZ.
J Bronchology Interv Pulmonol. 2018 Apr;25(2):144-147. doi: 10.1097/LBR.0000000000000435.
The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) has traditionally been limited to a narrow set of clinical circumstances, such as acute hypoxic respiratory failure, submassive pulmonary embolism, and cardiopulmonary collapse. Within the pediatric population, there have been cases of VV-ECMO in the context of extrinsic airway compression by a mediastinal mass, typically in the setting of either a lymphoma or germ cell tumors. However, the use of VV-ECMO for adults with extrinsic airway compression is comparatively limited. More specifically, VV-ECMO has been used as a bridge for tracheal reconstruction in both children and adults. Although, it has not been used in adults in the context of palliative endobronchial stent placement. We present a case of a 49-year-old woman with refractory multiple myeloma and extramedullary plasmacytoma presenting with acute hypoxic respiratory failure from extrinsic airway compression by a mediastinal plasmacytoma. We were able to use VV-ECMO to assist with endobronchial stent placement, followed by radiation therapy, and ultimately hospital discharge. In this article, we also review the literature surrounding VV-ECMO for extrinsic airway compression.
静脉-静脉体外膜肺氧合（VV-ECMO）的应用传统上局限于狭窄的临床情况，如急性低氧性呼吸衰竭、次大面积肺栓塞和心肺骤停。在儿科人群中，存在纵隔肿物导致气道外压情况下使用VV-ECMO的病例，通常见于淋巴瘤或生殖细胞肿瘤。然而，对于气道外压的成年患者，VV-ECMO的应用相对有限。更具体地说，VV-ECMO已被用作儿童和成人气管重建的桥梁。尽管如此，它尚未用于姑息性支气管内支架置入的成年患者。我们报告一例49岁女性难治性多发性骨髓瘤和髓外浆细胞瘤患者，因纵隔浆细胞瘤导致气道外压出现急性低氧性呼吸衰竭。我们能够使用VV-ECMO辅助进行支气管内支架置入，随后进行放射治疗，最终患者出院。在本文中，我们还回顾了关于VV-ECMO用于气道外压的相关文献。
