Department of Thoracic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
Department of Critical Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.
Eur J Cardiothorac Surg. 2021 Jun 14;59(6):1345-1346. doi: 10.1093/ejcts/ezaa425.
Tracheobronchial stent insertion is a common palliative intervention for the management of dynamic airway collapse due to severe tracheobronchomalacia or tracheal compression due to mass effect [1]. Airway stents are usually placed bronchoscopically with or without fluoroscopy. In more complex cases, airway stents are placed using a rigid bronchoscope under general anaesthesia with conventional or jet ventilation. In patients where advancement of a rigid bronchoscope into the distal airway or ventilation through a rigid bronchoscope may be difficult, pre-emptive awake veno-venous extracorporeal membrane oxygenation should be considered. This report is the first publication to describe a novel technique in a series of patients being treated for critical airway obstruction who would otherwise be at risk of respiratory arrest at the induction of anaesthesia.
气管支气管支架置入术是一种常见的姑息性干预措施，用于治疗因严重气管支气管软化或肿块效应导致的动态气道塌陷[1]。气道支架通常经支气管镜插入，有或无透视。在更复杂的情况下，气道支架通过全身麻醉下的硬质支气管镜插入，使用常规或射流通气。在硬质支气管镜难以进入远端气道或通气的患者中，应考虑预防性清醒静脉-静脉体外膜肺氧合。本报告是首例描述一系列因严重气道阻塞而接受治疗的患者的新型技术，否则这些患者在麻醉诱导时可能会有呼吸停止的风险。
