Yamada Yu, Ohata Toshihiro, Kitahara Mutsunori, Kohata Hisakazu, Kumasawa Junji, Kohno Michihiko
Department of Cardiovascular Surgery, Sakai City Medical Center, Ebaraji-cho 1-1-1, Nishi-ku, Sakai, Osaka, 593-8304, Japan.
Department of Critical Care Medicine, Sakai City Medical Center, Ebaraji-cho 1-1-1, Nishi-ku, Sakai, Osaka, 593-8304, Japan.
J Artif Organs. 2018 Dec;21(4):479-481. doi: 10.1007/s10047-018-1070-1. Epub 2018 Oct 5.
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is used not only support gas transfer of patients suffering from respiratory failure, but also to manage hypoxic patients with critical airway obstruction during various procedures. We present a case in which we electively used VV-ECMO to facilitate tube placement and tracheal biopsy in a 67-year-old female with critical tracheal stenosis. The patient was transferred to our hospital for a surgical treatment after emergent tracheostomy for postoperative management of cerebral hemorrhage in right putamen. Her trachea was severely stenotic and just enough for a 5.5 mm tracheostomy tube. Removal of tracheostomy tube, tracheal wall biopsy and intra-tracheal tube placement were successfully performed under VV-ECMO support, drainage from inferior vena cava returned into the right ventricle (RV). RV perfusion was a very useful and effective method in VV-ECMO system, although some careful wire management was needed under fluoroscopic guidance.
静脉-静脉体外膜肺氧合（VV-ECMO）不仅用于支持呼吸衰竭患者的气体交换，还用于在各种手术过程中处理气道严重阻塞的低氧患者。我们报告了一例67岁女性严重气管狭窄患者，我们选择性地使用VV-ECMO来协助放置气管导管和进行气管活检。该患者因右侧壳核脑出血行紧急气管切开术后转至我院接受手术治疗。她的气管严重狭窄，仅能容纳一根5.5毫米的气管切开导管。在VV-ECMO支持下，成功进行了气管切开导管拔除、气管壁活检和气管内导管置入，下腔静脉引流回流入右心室（RV）。尽管在荧光镜引导下需要小心处理导丝，但右心室灌注在VV-ECMO系统中是一种非常有用且有效的方法。
