Veno-venous extracorporeal membrane oxygenation and apnoeic oxygenation for tracheo-oesophageal fistula repair in a previously pneumonectomised patient

N. F. Collins, L. Ellard, E. Licari, E. Beasley, S. Seevanayagam, L. Doolan

Research output: Contribution to journalArticleOtherpeer-review

9 Citations (Scopus)

Abstract

The use of extracorporeal membrane oxygenation (ECMO) for elective thoracic surgical procedures has been infrequently reported in the anaesthetic literature. We report the use of intraoperative veno-venous ECMO support for a patient with a previous left pneumonectomy who required a right-sided thoracotomy for repair of a tracheo-oesophageal fistula. To avoid traumatising or pressurising the fistula, a spontaneous ventilation technique was used prior to intubation with a single-lumen endotracheal tube positioned above the level of the fistula. The ECMO cannulas were inserted after induction and ECMO was instituted prior to transfer to the lateral position. Oxygenation during ECMO was augmented with apnoeic oxygen delivery via the breathing circuit. This was associated with an increase in the oxygen saturations from 80% to 99% without compromising surgical access. The use of apnoeic oxygenation via the breathing circuit significantly improved gas exchange in this case and should be considered as an adjunct to veno-venous ECMO.

Original languageEnglish
Pages (from-to)789-792
Number of pages4
JournalAnaesthesia and Intensive Care
Volume42
Issue number6
Publication statusPublished - 1 Nov 2014
Externally publishedYes

Keywords

  • apnoeic oxygenation
  • complex thoracic surgery
  • ECMO
  • tracheo-oesophageal fistula

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