Introduction:
The indications for extracorporeal membrane oxygenation (ECMO) have expanded as the technology has become an integral component of extracorporeal life support (ECLS). Drs. Gibbon, Rashkind, and Dorson described the use of ECMO in the 1950s and 1960s for cardio-pulmonary failure in neonates and subsequently expanded to the adult population1.
In addition to standard indications in patients with parenchymal lung failure, ECMO has been used to achieve stable oxygenation/ventilation in the peri- and intra-operative period prior to re-establishment of airway patency in patients with critical tracheal stenosis secondary to tracheal tumors or mediastinal mass/neoplasms causing extrinsic airway compression2. Critical tracheal stenosis defined as greater than 75% narrowing of the airway lumen that is often associated with extreme respiratory distress and difficult intubation3. Although not novel, the use of intra-operative ECMO in cases of critical tracheal stenosis has not frequently been described. We present a case of a large right paratracheal mass that significantly compressed the intrathoracic trachea; VV ECMO was instituted to allow safe endotracheal intubation and lung isolation to resect the lesion and relieve the tracheal stenosis. Institutional Review Board and informed consent waiver are included in our supplementary files.