[Anesthetic management with veno-venous extracorporeal membrane oxygenator (VV-ECMO) in a patient with severe tracheobronchial stenosis].
We conducted an anesthetic management to perform tracheostomy and tracheolysis in a 33 year-old female with severe stenosis extending to the lower trachea and right main bronchus. The minimal diameter of the stenotic lesion of the trachea was 3 mm according to the preoperative examinations including tomography, CT scan and magnetic resonance imaging. Since there was a high risk of airway collapse during anesthetic induction that could have made ventilation impossible, we decided to apply VV-ECMO to support gas-exchange prior to anesthetic induction. Blood gas analysis showed good results, and sufficient oxygenation and stable circulation were achieved during surgical procedures. Total intravenous anesthesia with propofol and fentanyl could provide adequate depth of anesthesia during surgery and rapid recovery with good spontaneous respiration after the termination of the infusion. VV-ECMO was a useful method to support gas-exchange in a case not requiring circulatory assistance without uneven oxygenation sometimes observed in VA-ECMO.
Kurokawa
S
S
Department of Anesthesiology, School of Medicine, Niigata University, Niigata 951-8510.
Tobita
T
T
Taga
K
K
Fukuda
S
S
Shimoji
K
K
Watanabe
T
T
Tsuchida
M
M
Yamato
Y
Y
D000328:Adult; D000771:Anesthesia, Intravenous; D001982:Bronchial Diseases / Q000209:etiology / Q000601:surgery*; D016084:Bronchoconstriction; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D019990:Perioperative Care; D012720:Severity of Illness Index; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D014139:Tracheostomy; D014397:Tuberculosis, Pulmonary / Q000150:complications