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The Use of Extracorporeal Membrane Oxygenation in the Surgical Repair of Bronchial Rupture

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Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.

Abstract

Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.

참고문헌 (7)

  1. Cordell-Smith JA, "Traumatic lung injury treated by extracorporeal membrane oxygenation (ECMO)", Injury, 37, pp.29~32 (2006)
  2. Sian K, "The use of extracorporeal membrane oxygenation therapy in the delayed surgical repair of a tracheal injury", Ann Thorac Surg, 97, pp.338~340 (2014)
  3. Liu C, "Extracorporeal membrane oxygenation as a support for emergency bronchial reconstruction in a traumatic patient with severe hypoxaemia", Interact Cardiovasc Thorac Surg, 19, pp.699~701 (2014)
  4. Ried M, "Extracorporeal lung support in trauma patients with severe chest injury and acute lung failure: a 10-year institutional experience", Crit Care, 17, pp.R110~ (2013)
  5. Korvenoja P, "Veno-venous extracorporeal membrane oxygenation in surgery for bronchial repair", Ann Thorac Surg, 86, pp.1348~1349 (2008)
  6. Peragallo RA, "Congenital tracheal bronchus:the inability to isolate the right lung with a univent bronchial blocker tube", Anesth Analg, 91, pp.300~301 (2000)
  7. Ventetuolo CE, "Extracorporeal life support in critically ill adults", Am J Respir Crit Care Med, 190, pp.497~508 (2014)

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