The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Gemma MalpasRobert D Hart

Abstract

While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management.Thirty-six papers were retrieved discussing the use of ECMO or cardiopulmonary bypass (CPB) for the management of critical airway obstruction. Forty-five patients underwent pre-induction of anesthesia institution of CPB or ECMO for airway obstruction. The patients presenting with critical airway obstruction had a range of airway pathologies with tracheal tumours (31%), tracheal stenosis (20%), and head and neck cancers (20%) being the most common. All cases reported a favourable patient outcome with all patients surviving to hospital ...Continue Reading

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Citations

Jun 7, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Orlando HungChrison Wong
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Oct 6, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Orlando HungMichael Murphy

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