Extracorporeal Membrane Oxygen Assisted Intubation for Complex Airways
Year: 2025
Type: article
Study design: Case Report
Abstract: OBJECTIVE: Airway management in patients with severely-narrowed tracheal lumens presents significant challenges, especially when traditional intubation methods are not feasible. In such cases, failed intubation attempts can worsen airway compromise and cause life-threatening complications. Extracorporeal membrane oxygenation (ECMO) offers an alternative approach to ensure oxygenation and ventilation during complex airway surgeries. The objective of this study was to assess the safety and feasibility of using venovenous ECMO to ensure oxygenation before attempting intubation in patients with severely-narrowed tracheal lumens undergoing head and neck surgery. METHODS: This is a retrospective case series of 3 adult patients who underwent venovenous ECMO-assisted intubation for head and neck surgeries at a single institution between 2010 and 2023. The primary outcome was the successful establishment of an airway and the avoidance of respiratory failure during the surgical procedure. RESULTS: All 3 patients successfully underwent ECMO-assisted intubation. None of the patients experienced major complications directly attributable to ECMO, and all were extubated within 24 hours postoperatively. CONCLUSIONS: Venovenous ECMO provides an effective strategy for managing difficult airways in patients with severely-narrowed tracheas, enabling safe anesthesia induction. This technique may be crucial in preventing complications associated with traditional airway management methods.
Source: Ear Nose & Throat Journal
Authors: Ritu V. Bhalerao, Michael L. Hinni, Kristen A. Sell-Dottin, Brent A. Chang
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
OpenAlex ID: W4413357182