Anesthetic experience of extracorporeal membrane oxygenation-assisted bronchial stenting in a patient with left bronchial stenosis complicated by severe right pulmonary artery stenosis

Abstract

　Bronchial stenting was performed under general anesthesia in a patient who received veno-venous extracorporeal membrane oxygenation (V-V ECMO) for severe stenoses in the left main bronchus and right pulmonary artery owing to mediastinal lung cancer. When the left main bronchus was open, oxygen saturation (SpO₂) was maintained within 90%~100%. However, when the left bronchus was occluded, SpO₂ decreased to 80%~90%. After the flow volume of the V-V ECMO was increased, SpO2 was maintained within 90%~100%. When severe bronchial stenosis is unilateral, the instability of pulmonary circulation in the ventilable lung may worsen the ventilation-perfusion imbalance, making it difficult to maintain oxygenation. V-V ECMO may be useful in maintaining oxygenation during bronchial stenting in patients with unstable pulmonary circulation.