Extracorporeal Membrane Oxygenation Without Mechanical Ventilation for Recovery From Tracheal Repair

Postoperative positive pressure ventilation (PPV) can contribute to failure of large intrathoracic airway repairs. We report a case of a 67-year-old woman with severe emphysema who presented with an unstable airway and mediastinitis after full-length transmural intrathoracic tracheal intubation injury. After repair, neither extubation nor PPV distal to the repair was feasible. To promote healing, we used prolonged venovenous extracorporeal membrane oxygenation (13 days) without any postoperative PPV. To our knowledge, this approach has not been previously described but may prove invaluable in select patients.