Journal of thoracic disease · 2026
Narrative review of extracorporeal membrane oxygenation utilization in surgical management of tracheal intubation injuries.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Parr Alan R, Liles Jonathan T, Malik Mohammad J, Morgan Clinton T
Аннотация
BACKGROUND AND OBJECTIVE: Tracheobronchial injuries are a rare complication of intubation but carry a high mortality. When surgical airway repair is necessary, veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be required to maintain gas exchange. To better understand contemporary utilization of VV-ECMO in surgical airway repairs, we undertook a comprehensive literature review.
METHODS: Using the PubMed database, we identified 1,013 potentially relevant publications and 13 of these, describing 14 patient cases, met criteria.
KEY CONTENT AND FINDINGS: Demographics and histories were consistent with prior studies of intubation injuries and included a female predominance (93%) and a high rate of emergent (64%) as well as double-lumen endotracheal tube (ETT) (14%) intubations. Injury length was 3.9±1.7 [mean ± standard deviation (SD)] centimeters (cm). Notably, injuries were located in the membranous airway in all cases (N=12) where injury location was reported. VV-ECMO was used in all cases, but cannulation configuration varied. Anticoagulation was used in 36% of cases upon VV-ECMO initiation and an additional 14% added anticoagulation post-operatively. Postoperative complications included one patient with both a perforated duodenal ulcer and a deep venous thrombosis (DVT), one surgical re-exploration for bleeding, one case of pneumonia with subsequent sepsis, and one patient with bilateral vision loss attributed to hypoxemia with resolution following a 2-day course of steroids. VV-ECMO duration ranged from 0 to 14 days with a mean of 4.3±4.7 days. Average length of stay was 24.9±16.6 days. Importantly, we identified four cases in which VV-ECMO was used post-operatively to reduce (3 cases) or eliminate (1 case) post-operative positive pressure ventilation (PPV) with a goal of decreasing repair failure.
CONCLUSIONS: Taken together, these findings extend our understanding of iatrogenic intubation injuries of the airway and their operative management with VV-ECMO support.
METHODS: Using the PubMed database, we identified 1,013 potentially relevant publications and 13 of these, describing 14 patient cases, met criteria.
KEY CONTENT AND FINDINGS: Demographics and histories were consistent with prior studies of intubation injuries and included a female predominance (93%) and a high rate of emergent (64%) as well as double-lumen endotracheal tube (ETT) (14%) intubations. Injury length was 3.9±1.7 [mean ± standard deviation (SD)] centimeters (cm). Notably, injuries were located in the membranous airway in all cases (N=12) where injury location was reported. VV-ECMO was used in all cases, but cannulation configuration varied. Anticoagulation was used in 36% of cases upon VV-ECMO initiation and an additional 14% added anticoagulation post-operatively. Postoperative complications included one patient with both a perforated duodenal ulcer and a deep venous thrombosis (DVT), one surgical re-exploration for bleeding, one case of pneumonia with subsequent sepsis, and one patient with bilateral vision loss attributed to hypoxemia with resolution following a 2-day course of steroids. VV-ECMO duration ranged from 0 to 14 days with a mean of 4.3±4.7 days. Average length of stay was 24.9±16.6 days. Importantly, we identified four cases in which VV-ECMO was used post-operatively to reduce (3 cases) or eliminate (1 case) post-operative positive pressure ventilation (PPV) with a goal of decreasing repair failure.
CONCLUSIONS: Taken together, these findings extend our understanding of iatrogenic intubation injuries of the airway and their operative management with VV-ECMO support.