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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.

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/c361e17eeb0b/TCA-15-2514-g001.jpg

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