RT Journal Article
SR Electronic
T1 Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty
JF Respiratory Care
FD American Association for Respiratory Care
SP 1198
OP 1202
DO 10.4187/respcare.00948
VO 56
IS 8
A1 Jenni Raake
A1 BethAnn Johnson
A1 Brandy Seger
A1 Peter B Manning
A1 Pirooz Eghtesady
A1 Paul Boesch
A1 Michael Rutter
A1 Amanda Woodard
A1 Ranjit S Chima
YR 2011
UL http://rc.rcjournal.com/content/56/8/1198.abstract
AB Long-segment congenital tracheal stenosis is characterized by complete tracheal rings. Surgery is required during infancy to optimize outcomes, and the post-surgery complications include mucus plugging, airway trauma, dehiscence at the surgery site, and death. We report a 5-week-old patient who developed a tracheal-wall dehiscence after a slide tracheoplasty. To safeguard against further dehiscence and to protect her one functional lung, we used extracorporeal membrane oxygenation (ECMO). After she was stabilized on veno-arterial ECMO we extubated and continued ECMO for 5 days. On postoperative day 14 we removed the ECMO and transitioned her to high-frequency oscillatory ventilation, and performed slow lung-recruitment maneuvers every 2 hours. This strategy of ECMO with extubation, then high-frequency oscillatory ventilation is a useful rescue therapy in patients with postoperative tracheal dehiscence.