Department of Anesthesiology, Université Catholique de Louvain, CHU UCL Namur, Site Godinne, Yvoir, Belgium.
Division of Pulmonology, Université Catholique de Louvain, CHU UCL Namur, Site Godinne, Yvoir, Belgium.
Can Respir J. 2021 Mar 18;2021:8822591. doi: 10.1155/2021/8822591. eCollection 2021.
Airway stenting offers good palliation and improves the quality of life in patients with inoperable bronchotracheal stenosis. However, in some cases, the management of stenting can be life-threatening. Hence, a strategy for maintaining oxygenation and hemodynamic stability should be anticipated to avoid critical situations. Herein, we report the use of extracorporeal membrane oxygenation (ECMO) in bronchotracheal stenting management to secure oxygenation and facilitate interventions.
We retrospectively reviewed all patients who underwent rigid bronchoscopy under ECMO support for the management of bronchotracheal stenting at CHU UCL Namur hospital (Belgium), between January 2009 and December 2019.
We included 14 bronchoscopy cases performed on 11 patients (3 patients underwent 2 bronchoscopies) in this study; 12 were performed on males and 2 on females. The median age was 54 years. There were 11 benign and 3 malignant etiologies for the central airway obstruction/stenosis. Eight cases were supported by venovenous ECMO and six by venoarterial ECMO. The median ECMO time was 267 minutes. The weaning of ECMO support was successful in all cases. In most cases, the procedures were performed effectively and safely. Only two local complications caused by the cannulation of ECMO were reported, and anticoagulation was adapted to avoid bleeding at the operating site and clot formation in the system.
Elective ECMO support was helpful and safe for the high-risk management of bronchotracheal stenting with rigid bronchoscopy and was not associated with any additional significant complications.
气道支架置入术可为无法手术的支气管-气管狭窄患者提供良好的姑息治疗，并提高生活质量。然而，在某些情况下，支架的管理可能危及生命。因此，应预测维持氧合和血液动力学稳定的策略，以避免危急情况。在此，我们报告了使用体外膜肺氧合（ECMO）在支气管-气管支架置入术管理中以确保氧合和便于干预。
我们回顾性审查了 2009 年 1 月至 2019 年 12 月期间，在 CHU UCL Namur 医院（比利时）接受 ECMO 支持下进行的刚性支气管镜检查以管理支气管-气管支架置入术的所有患者。
我们纳入了 14 例在 11 例患者中进行的支气管镜检查（3 例患者进行了 2 次支气管镜检查）；12 例为男性，2 例为女性。中位年龄为 54 岁。11 例为良性，3 例为恶性病因导致的中央气道阻塞/狭窄。8 例采用静脉-静脉 ECMO 支持，6 例采用静脉-动脉 ECMO 支持。中位 ECMO 时间为 267 分钟。所有病例均成功撤机 ECMO 支持。在大多数情况下，手术都有效且安全地进行。仅报告了 2 例由 ECMO 置管所引起的局部并发症，通过调整抗凝治疗以避免手术部位出血和系统内血栓形成。
选择性 ECMO 支持对于高风险的支气管-气管支架置入术的刚性支气管镜检查是有益和安全的，并且不会引起任何其他显著的并发症。
