PT  - JOURNAL ARTICLE
AU  - Jenni Raake
AU  - BethAnn Johnson
AU  - Brandy Seger
AU  - Peter B Manning
AU  - Pirooz Eghtesady
AU  - Paul Boesch
AU  - Michael Rutter
AU  - Amanda Woodard
AU  - Ranjit S Chima
TI  - Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty
AID  - 10.4187/respcare.00948
DP  - 2011 Aug 01
TA  - Respiratory Care
PG  - 1198--1202
VI  - 56
IP  - 8
4099  - http://rc.rcjournal.com/content/56/8/1198.short
4100  - http://rc.rcjournal.com/content/56/8/1198.full
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.