Nonoperative Damage Control: The Use of Extracorporeal Membrane Oxygenation in Traumatic Bronchial Avulsion as a Bridge to Definitive Operation

Document Type

Article

Publication Date

6-1-2016

Publication Title

The Annals of thoracic surgery

Abstract

The conventional treatment for an avulsed bronchus is emergent thoracotomy and repair or lobectomy. The principles of damage control thoracic operations include initial hemorrhage control with delayed definite repair after physiologic resuscitation. We report a multiply injured patient with avulsion of the left lower lobe bronchus. Profound acidosis, hypercarbia, and hypoxia precluded an emergent operation, and venovenous extracorporeal membrane oxygenation (V-V ECMO) was used for organ support during physiologic resuscitation. After the achievement of physiologic repletion, a thoracotomy and lobectomy were performed while the patient was supported by V-V ECMO.

Medical Subject Headings

Accidents, Traffic; Adult; Bronchi; Cardiotonic Agents; Chest Tubes; Debridement; Emergencies; Empyema, Pleural; Epoprostenol; Extracorporeal Membrane Oxygenation; Female; Humans; Intubation, Intratracheal; Pneumonectomy; Preoperative Care; Renal Replacement Therapy; Respiratory Insufficiency; Staphylococcal Infections; Thoracotomy; Wounds, Nonpenetrating

PubMed ID

27211954

Volume

101

Issue

6

First Page

2384

Last Page

2386

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