Application of extracorporeal membrane oxygenation (ECMO) for airway stenting using rigid bronchoscopy

Abstract

Airway obstruction can be caused by tracheobronchial stenting when there is severe central tracheal stenosis. In such cases, Extracorporeal Membrane Oxygenation (ECMO) is useful for oxygenation. Cases of applying ECMO involving a danger of suffocation are rare, and there have been few studies on cannulation sites. We examined appropriate cannulation sites of ECMO for oxygenation, especially for the upper body, in the procedure of tracheobronchial stenting. We examined 11 cases of tracheobronchial stenting with ECMO support performed in our facility from November 1998 to August 2014. Severe central stenosis was seen in all 11 cases, and airway obstruction during stenting was considered to be possible. The number of cases which maintained head-SpO2 over 90% was 0/2 in Venous-Venous (V-V) ECMO, 1/5 in Veno-Femoral Artery (V-FA) ECMO, and 4/4 in Veno-Subclavian Artery (V-SA) ECMO. Because of the circuit characteristics, V-SA may be safer than V-V and V-FA in the case of stenting for severe airway stenosis.