Lee Yong Ki, Park Sang Hyun, Hwang Jin Young, Ryu Choon Gun, Kim Jin Hee, Han Sung Hee
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2009 Oct;57(4):522-527. doi: 10.4097/kjae.2009.57.4.522.
The airway management for patients with critical airway problems continues to be a challenge to the anesthesiologist. In general cases, conventional ventilation techniques have been used successfully. These include fiberoptic bronchoscope guided intubation, supraglottic airway, endotracheal or endobronchial intubation at operative field, high frequency jet ventilation, etc. However, patients with near-fatal airway obstruction or severely depressed pulmonary function that is refractory to conventional ventilation methods also present. In these cases, cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO) can be used. Although these situations are uncommon indications for ECMO, ECMO can be a potential option for these life threatening conditions. Especially, venovenous (VV) ECMO can be used for pure pulmonary support. We describe three cases of airway surgery requiring ECMO. VV ECMO was established in all cases. ECMO provided adequate temporary pulmonary support and all patients weaned from ECMO successfully without any complication.
对患有严重气道问题的患者进行气道管理，仍然是麻醉医生面临的一项挑战。在一般情况下，传统的通气技术已成功应用。这些技术包括纤维支气管镜引导插管、声门上气道、术野气管内或支气管内插管、高频喷射通气等。然而，也存在气道梗阻接近致命或肺功能严重受损且对传统通气方法无效的患者。在这些情况下，可以使用体外循环或体外膜肺氧合（ECMO）。尽管这些情况是ECMO的罕见适应证，但ECMO对于这些危及生命的状况可能是一种潜在的选择。特别是，静脉-静脉（VV）ECMO可用于单纯的肺支持。我们描述了3例需要ECMO的气道手术病例。所有病例均建立了VV ECMO。ECMO提供了足够的临时肺支持，所有患者均成功撤离ECMO，无任何并发症。
