AI Article Synopsis
- Long-segment congenital tracheal stenosis involves complete tracheal rings, necessitating surgical intervention in infancy due to risks like mucus plugging and airway trauma.
- A case is reported of a 5-week-old infant who experienced tracheal-wall dehiscence after slide tracheoplasty and required extracorporeal membrane oxygenation (ECMO) for stabilization.
- The treatment approach included extubation after ECMO setup, followed by high-frequency oscillatory ventilation and regular lung-recruitment maneuvers, indicating this method can be effective for managing postoperative complications.
Article Abstract
Long-segment congenital tracheal stenosis is characterized by complete tracheal rings. Surgery is required during infancy to optimize outcomes, and the post-surgery complications include mucus plugging, airway trauma, dehiscence at the surgery site, and death. We report a 5-week-old patient who developed a tracheal-wall dehiscence after a slide tracheoplasty. To safeguard against further dehiscence and to protect her one functional lung, we used extracorporeal membrane oxygenation (ECMO). After she was stabilized on veno-arterial ECMO we extubated and continued ECMO for 5 days. On postoperative day 14 we removed the ECMO and transitioned her to high-frequency oscillatory ventilation, and performed slow lung-recruitment maneuvers every 2 hours. This strategy of ECMO with extubation, then high-frequency oscillatory ventilation is a useful rescue therapy in patients with postoperative tracheal dehiscence.
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| http://dx.doi.org/10.4187/respcare.00948 | DOI Listing |
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