title: Use of venovenous extracorporeal membrane oxygenation in central airway obstruction to facilitate interventions leading to definitive airway security.
abstract: OBJECTIVE
  Extracorporeal membrane oxygenation (ECMO) is useful for providing hypoxic patients with ventilatory support, but its usefulness in the management of patients with central airway obstruction has rarely been reported. Nineteen cases in one center where venovenous (VV) ECMO was used to support patients with severe central airway obstruction while they underwent lifesaving interventions are reported here.
  
  
  METHODS
  In total, 113 cases of VV ECMO were performed in Asan Medical Center between January 2009 and June 2012. In 19 cases (18 patients), VV ECMO was used to support patients with severe airway obstruction.
  
  
  RESULTS
  Of the 18 patients, 13 were male, and their median age was 62.5 (range, 16-82) years. The main reasons for using ECMO to provide airway security were malignant mass removal with a rigid bronchoscope (8 cases) and insertion of a tracheal stent (7 cases). The median ECMO time was 20.9 (range, 2.2-113.4) hours. In 1 case, a patient died of massive bleeding after a malignant mass was removed. Weaning off ECMO therapy occurred successfully in the remaining 18 cases.
  
  
  CONCLUSIONS
  Venovenous ECMO may be useful in patients with central airway obstruction because it provides short-term airway security while lifesaving procedures are being performed.
authors.affiliation: Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea.
authors.forename: Yoonki
authors.initials: Y
authors.lastname: Hong
authors.forename: Kyung-Wook
authors.initials: KW
authors.lastname: Jo
authors.forename: Jiwon
authors.initials: J
authors.lastname: Lyu
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Huh
authors.forename: Sang Bum
authors.initials: SB
authors.lastname: Hong
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Jung
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy*; D001999:Bronchoscopy; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Central airway obstruction; Rigid bronchoscopy; Tracheal stent; Venovenous extracorporeal membrane oxygenation (VV ECMO)