Successful Management of Airway Emergency in a Patient with Esophageal Cancer

• Main Authors: Samina Park, Hyun Joo Lee, Chang Hyun Kang, Young Tae Kim
• Format: Article
• Language: English
• Published: Korean Society of Critical Care Medicine 2015-05-01
• Series: Korean Journal of Critical Care Medicine
• Subjects: airway management; esophageal neoplasm; extracorporeal membrane oxygenation; tracheal stenosis
• Online Access: http://www.kjccm.org/upload/pdf/kjccm-2015-30-2-135.pdf

A 60-year-old man with advanced esophageal cancer was admitted for surgical placement of a feeding jejunostomy tube before commencement of chemoradiotherapy. His esophageal cancer had directly invaded the posterior tracheal wall, inducing a nearly total obstruction of the distal trachea. On the day before the surgery, respiratory failure developed due to tumor progression and tracheal edema. Tracheal intubation and mechanical ventilation were attempted without success. Application of veno-venous extracorporeal membrane oxygenation (ECMO) corrected the patient’s respiratory acidosis and relieved his dyspnea. With full ECMO support, he underwent tracheal stent insertion. Two hours later, he was weaned from ECMO support uneventfully. This was a successful case of tracheal stenting for airway obstruction under rescue veno-venous ECMO.