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体外膜肺氧合支持下的肺切除术后严重中央气道梗阻的内镜切除术

ECMO support for endoscopic resection of postpneumonectomy critical central airway obstruction.

作者信息

Fiorelli Alfonso, De Feo Marisa, Torella Michele, Ferraro Fausto, Bianco Andrea, Vicario Giuseppe, Capasso Francesca, Messina Gaetana, Natale Giovanni

机构信息

Thoracic Surgery Unit, Department of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

Cardiothoracic Unit, Department of Translational Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.

出版信息

Thorac Cancer. 2024 Dec;15(35):2514-2516. doi: 10.1111/1759-7714.15456. Epub 2024 Oct 29.

DOI:10.1111/1759-7714.15456
PMID:39472769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11646687/
Abstract

A 73-year-old woman was admitted to our hospital with severe respiratory distress due to postpneumonectomy neoplastic central airway obstruction. An emergency recanalization with rigid bronchoscopy (RB) was planned. Controlled and jet ventilation are routinely used to assure ventilation during RB, but the risk of inadequate oxygenation and removal of carbon dioxide was prohibitively high in this case due to the presence of a single lung. The use of venovenous extracorporeal membrane oxygenation was decided by multidisciplinary team to support ventilation during RB. Complete airway recanalization was successfully achieved without any complications. The patient was discharged 2 days later. Pathology revealed metastatic adenocarcinoma, and the patient was reviewed for oncologic treatment.

摘要

一名73岁女性因肺切除术后肿瘤性中央气道阻塞导致严重呼吸窘迫入住我院。计划进行硬质支气管镜(RB)紧急再通术。在RB期间,通常使用控制通气和喷射通气来确保通气,但由于该患者仅存单肺,氧合不足和二氧化碳清除的风险极高。多学科团队决定使用静脉-静脉体外膜肺氧合来支持RB期间的通气。成功实现了气道完全再通,无任何并发症。患者于2天后出院。病理检查显示为转移性腺癌,患者接受了肿瘤治疗评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/11646687/ae45b4bb2436/TCA-15-2514-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/11646687/c361e17eeb0b/TCA-15-2514-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/11646687/ae45b4bb2436/TCA-15-2514-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/11646687/c361e17eeb0b/TCA-15-2514-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/11646687/ae45b4bb2436/TCA-15-2514-g003.jpg

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本文引用的文献

1
Concomitant Intubation with Minimal Cuffed Tube and Rigid Bronchoscopy for Severe Tracheo-Carinal Obstruction.联合使用最小号带套囊气管导管插管与硬质支气管镜治疗严重气管隆突梗阻
J Clin Med. 2023 Aug 12;12(16):5258. doi: 10.3390/jcm12165258.
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Establishing the Ideal Conditions to Create an Airway Fire Using a Porcine Airway Model.利用猪气道模型建立引发气道火灾的理想条件。
OTO Open. 2023 Feb 23;7(1):e36. doi: 10.1002/oto2.36. eCollection 2023 Jan-Mar.
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One-Lung Ventilation during Rigid Bronchoscopy Using a Single-Lumen Endotracheal Tube: A Descriptive, Retrospective Single-Center Study.
使用单腔气管导管在硬质支气管镜检查期间进行单肺通气:一项描述性、回顾性单中心研究。
J Clin Med. 2023 Mar 21;12(6):2426. doi: 10.3390/jcm12062426.
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Thorac Cancer. 2023 Jan;14(1):24-29. doi: 10.1111/1759-7714.14671. Epub 2022 Nov 23.
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Bronchotracheal Stenting Management by Rigid Bronchoscopy under Extracorporeal Membrane Oxygenation (ECMO) Support: 10 Years of Experience in a Tertiary Center.体外膜肺氧合(ECMO)支持下硬质支气管镜支气管-气管支架置入管理:三级中心 10 年经验
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Anaesth Rep. 2020 Oct 15;8(2):120-122. doi: 10.1002/anr3.12064. eCollection 2020 Jul-Dec.
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Elective extra corporeal membrane oxygenation for high-risk rigid bronchoscopy.择期体外膜肺氧合用于高危硬质支气管镜检查。
Thorax. 2020 Nov;75(11):994-997. doi: 10.1136/thoraxjnl-2020-214740. Epub 2020 Jul 24.
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Montgomery T-tube for management of tracheomalacia: Impact on voice-related quality of life.用于治疗气管软化症的蒙哥马利T型管:对语音相关生活质量的影响。
Clin Respir J. 2020 Jan;14(1):40-46. doi: 10.1111/crj.13098. Epub 2019 Oct 23.
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