Mori Hitoshi, Kashiura Masahiro, Yoshimura Yuya, Yamahata Yuki, Tokura Tomohisa, Nodagashira Tatsuya, Konn Akihide, Moriya Takashi
Department of Emergency and Critical Care Medicine Hachinohe City Hospital Hachinohe Aomori Japan.
Present address: Department of Emergency and Critical Care Medicine Saitama Medical Center, Jichi Medical University Saitama Japan.
Acute Med Surg. 2024 Jul 14;11(1):e980. doi: 10.1002/ams2.980. eCollection 2024 Jan-Dec.
The use of venovenous extracorporeal membrane oxygenation (VV-ECMO), particularly during radiotherapy, for severe malignant central airway obstruction has rarely been reported.
A 47-year-old female presented to our emergency department with severe respiratory distress. Given her medical history, she was initially diagnosed with asthma. Despite initial treatment, which included intubation, her condition deteriorated, necessitating VV-ECMO. Computed tomography performed following the initiation of VV-ECMO revealed extensive lung cancer involving both bronchial types. Radiotherapy while on VV-ECMO led to a significant reduction in tumor size, allowing for the weaning of ECMO support and successful extubation.
Malignant central airway obstruction is life-threatening. Our case demonstrates the efficacy of combining VV-ECMO with radiotherapy when conventional therapies fail. Further research is necessary to validate and explore this novel approach's implications.
静脉-静脉体外膜肺氧合（VV-ECMO），尤其是在放疗期间用于治疗严重恶性中央气道阻塞的情况鲜有报道。
一名47岁女性因严重呼吸窘迫被送至我院急诊科。鉴于其病史，最初被诊断为哮喘。尽管进行了包括插管在内的初始治疗，但其病情仍恶化，需要VV-ECMO支持。在启动VV-ECMO后进行的计算机断层扫描显示广泛的肺癌累及两种支气管类型。在VV-ECMO支持下进行放疗导致肿瘤大小显著减小，从而得以撤掉ECMO支持并成功拔管。
恶性中央气道阻塞危及生命。我们的病例证明了在传统治疗失败时，将VV-ECMO与放疗相结合的有效性。有必要进行进一步研究以验证并探索这种新方法的意义。
