Extracorporeal membrane oxygenation, extubation, and lung-recruitment maneuvers as rescue therapy in a patient with tracheal dehiscence following slide tracheoplasty

Jenni Raake, Beth Ann Johnson, Brandy Seger, Peter B. Manning, Pirooz Eghtesady, Paul Boesch, Michael Rutter, Amanda Woodard, Ranjit S. Chima

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1198-1202
Number of pages5
JournalRespiratory care
Volume56
Issue number8
DOIs
StatePublished - Aug 1 2011

Keywords

  • ECMO
  • Extracorporeal membrane oxygenation
  • Lung-recruitment maneuver
  • Pulmonary agenesis
  • Slide tracheoplasty
  • Surgical wound dehiscence
  • Tracheal stenosis

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