title: Outcomes of Extracorporeal Life Support During Surgery for the Critical Airway Stenosis.
abstract: Anesthetic management of critical airway stenosis is often very challenging. Extracorporeal membrane oxygenation (ECMO) may provide adequate respiratory support when conventional approaches fail. We report our experience of ECMO support for critical airway surgery. Between April 2012 and March 2015, nine patients underwent ECMO-supported airway operation. The reason for surgery was tracheal stenosis in nine patients, and tracheomalacia, tracheal tumor, and external tracheal compression by mediastinal mass in one patient each. Resection and end-to-end anastomosis was performed in four patients; the remainder underwent diverse procedures, including tracheoplasty, tracheal ballooning, tracheostomy, and debulking of mediastinal mass. Extracorporeal membrane oxygenation support was sufficient for gas exchange during surgery and six patients were successfully weaned off intraoperatively. The median time on ECMO was 2.42 hours (range: 14.43-216 hours). No ECMO-related complications occurred. The median intensive care unit stay, median hospital stay, and mean follow-up period were 2 days (range: 1-61 days), 33 days (range: 9-303 days), and 17.1 ± 10.8 months, respectively. The rate of freedom from reintervention was 71.4%; the mean survival rates over 1 and 2 years were 76.2% and 63.5%, respectively. Our experience indicates that ECMO is a feasible and safe method for critical airway surgery.
authors.affiliation: From the *Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Biomedical Research Institute, Busan, Republic of Korea; and †Departments of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
authors.forename: Seon Hee
authors.initials: SH
authors.lastname: Kim
authors.forename: Seunghwan
authors.initials: S
authors.lastname: Song
authors.forename: Yeong Dae
authors.initials: YD
authors.lastname: Kim
authors.forename: Hoseok
authors.initials: H
authors.lastname: I
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Cho
authors.forename: Hyo Yeong
authors.initials: HY
authors.lastname: Ahn
authors.forename: Jonggeun
authors.initials: J
authors.lastname: Lee
authors.forename: Do Hyung
authors.initials: DH
authors.lastname: Kim
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Son
mesh_terms: D000293:Adolescent; D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*