Nonoperative Damage Control: The Use of Extracorporeal Membrane Oxygenation in Traumatic Bronchial Avulsion as a Bridge to Definitive Operation
Schmoekel NH, O'Connor JV, Scalea TM. Nonoperative Damage Control: The Use of Extracorporeal Membrane Oxygenation in Traumatic Bronchial Avulsion as a Bridge to Definitive Operation. Ann Thorac Surg. 2016 Jun;101(6):2384-6.
The Annals of thoracic surgery
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