Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty
Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty
复制标题
体外膜氧合、拔管和肺复张操作作为滑动气管成形术后气管裂开患者的抢救治疗
作者：
J. Raake;Bethann Johnson;Brandy Seger;P. Manning;P. Eghtesady;P. Boesch;M. Rutter;Amanda Woodard;Ranjit S. Chima
长段先天性气管狭窄以完整的气管环为特征。婴儿期需要手术以优化预后，术后并发症包括粘液堵塞、呼吸道损伤、手术部位裂开和死亡。我们报告一位5周大的病人，他在滑动气管成形术后发展为气管壁裂开。为了防止进一步的裂开和保护她的一个肺功能，我们使用了体外膜氧合(ECMO)。在静脉-动脉ECMO稳定下来后，我们拔管并继续ECMO 5天。在术后第14天，我们摘除ECMO并过渡到高频振荡呼吸机，每隔2小时进行一次缓慢的肺复张动作。这种ECMO拔管再高频振荡呼吸机的策略对术后气管裂开患者是一种有效的抢救方法。
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.
影响因子：
8.8
作者：
Froese, Alison B;Kinsella, John P
通讯作者：
Kinsella, John P