Extracorporeal Membrane Oxygen Assisted Intubation for Complex Airways

Area of Science:

• Anesthesiology
• Cardiovascular Surgery
• Respiratory Medicine

Background:

• Managing severely narrowed tracheal lumens poses significant airway management challenges.
• Failed intubation attempts in these patients can lead to critical airway compromise and complications.
• Extracorporeal membrane oxygenation (ECMO) offers a potential solution for maintaining oxygenation during complex procedures.

Purpose of the Study:

• To evaluate the safety and feasibility of using venovenous ECMO.
• To ensure adequate oxygenation prior to intubation attempts.
• In patients with severely narrowed tracheas undergoing head and neck surgery.

Main Methods:

• Retrospective case series of 3 adult patients.
• Venovenous ECMO utilized for airway management.
• Performed at a single institution from 2010 to 2023.

Main Results:

• Successful ECMO-assisted intubation in all 3 patients.
• No major ECMO-related complications observed.
• All patients were extubated within 24 hours post-surgery.

Conclusions:

• Venovenous ECMO is an effective strategy for difficult airway management.
• Enables safe anesthesia induction in patients with narrowed tracheas.
• Crucial for preventing complications associated with traditional intubation methods.