[Placement of self-expanding metallic stents in the stenotic trachea and bronchus under the support of gas exchange by extracorporeal lung assist (ECLA)].
Three self-expanding metallic stents (MS) were placed in a patient with severe dyspnea due to tracheo-bronchial stenosis caused by a large metastatic malignant tumor. To ensure adequate gas exchange, we used ECLA during surgery. After ECLA was started with V-V bypass (blood flow 1.3 l.min-1, 100% O2 flow 10 l.min-1), the patient was administered droperidol and fentanyl, and orotracheally intubated with an endotracheal tube (7.0 mm ID) using a bronchofiberscope. Anesthesia was maintained with midazolam, but no neuromuscular blocking agent was used. The pulmonary ventilation was withheld 3 times during each period of 5-10 min for MS placement through the endotracheal tube. The patient was ventilated for a few min between each procedure. Values of arterial blood gas were maintained within physiological ranges throughout the surgery. ECLA was a useful means of ensuring adequate gas exchange in perioperative patients with difficult airway.
Amakawa
K
K
Department of Anesthesiology and Resuscitology, Ehime University School of Medicine.
Tsuno
K
K
Adachi
N
N
Abe
S
S
Kii
N
N
Arai
T
T
D000293:Adolescent; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006493:Heparin; D006801:Humans; D007430:Intraoperative Care; D008874:Midazolam; D015607:Stents; D014135:Tracheal Stenosis / Q000601:surgery*
D018686:Anesthetics, Intravenous; D006493:Heparin; D008874:Midazolam