Extracorporeal membrane oxygenation as a bridge to definitive tracheal reconstruction in neonates

被引:18
作者
Kunisaki, Shaun M. [1 ]
Fauza, Dario O. [1 ]
Craig, Nancy [1 ]
Jennings, Russett W. [1 ]
机构
[1] Childrens Hosp, Dept Surg, Boston, MA 02115 USA
关键词
extracorporeal membrane oxygenation; ECMO; congenital tracheal stenosis; tracheal reconstruction;
D O I
10.1016/j.jpedsurg.2007.12.014
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: Infants born with severe tracheal anomalies may not survive beyond the first few hours of life without aggressive cardiopulmonary support and/or emergent airway surgery. The purpose of this study was to review our experience with critically ill neonates supported on extracorporeal membrane oxygenation (ECMO) before tracheal reconstruction. Methods: A retrospective review of a single institution ECMO registry was conducted. Outcomes of neonates requiring tracheal repair were examined. Results: Three children with tracheal anomalies (complete tracheal rings [n = 2]; bronchogenic cyst [n = 1]) underwent definitive airway reconstruction. All were placed on ECMO (venovenous [n = 2]; venoarterial [n 1]) within 24 hours after birth. Tracheoplasties (tracheal resection with end-to-end anastomosis [n = 1]; slide tracheoplasty [n = 1]; carinal resection and reconstruction [n = 1]) were performed at 3.7 +/- 2.2 days of life. There were no hemorrhagic or thrombotic complications for an ECMO time of 117.3 +/- 60.1 hours. The postoperative durations until extubation and hospital discharge were 12.0 +/- 3.2 and 34.3 +/- 11.6 days, respectively. All children remain alive and well without cardiopulmonary and neurologic sequelae at a mean follow-up of 4.5 years. Conclusions: Excellent clinical outcomes can be achieved in neonates born with severe tracheal anomalies using ECMO as a bridge to definitive tracheal reconstruction. Published by Elsevier Inc.
引用
收藏
页码:800 / 804
页数:5
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