Purpose. Airway stenting offers good palliation and improves the quality of life in patients with inoperable bronchotracheal stenosis. However, in some cases, the management of stenting can be life-threatening. Hence, a strategy for maintaining oxygenation and hemodynamic stability should be anticipated to avoid critical situations. Herein, we report the use of extracorporeal membrane oxygenation (ECMO) in bronchotracheal stenting management to secure oxygenation and facilitate interventions. Methods. We retrospectively reviewed all patients who underwent rigid bronchoscopy under ECMO support for the management of bronchotracheal stenting at CHU UCL Namur hospital (Belgium), between January 2009 and December 2019. Results. We included 14 bronchoscopy cases performed on 11 patients (3 patients underwent 2 bronchoscopies) in this study; 12 were performed on males and 2 on females. The median age was 54 years. There were 11 benign and 3 malignant etiologies for the central airway obstruction/stenosis. Eight cases were supported by venovenous ECMO and six by venoarterial ECMO. The median ECMO time was 267 minutes. The weaning of ECMO support was successful in all cases. In most cases, the procedures were performed effectively and safely. Only two local complications caused by the cannulation of ECMO were reported, and anticoagulation was adapted to avoid bleeding at the operating site and clot formation in the system. Conclusion. Elective ECMO support was helpful and safe for the high-risk management of bronchotracheal stenting with rigid bronchoscopy and was not associated with any additional significant complications.

中文翻译：

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在体外膜肺氧合 (ECMO) 支持下通过刚性支气管镜进行支气管气管支架置入管理：在三级中心拥有 10 年的经验

目的。气道支架可提供良好的缓和作用，并改善无法手术的支气管气管狭窄患者的生活质量。然而，在某些情况下，支架的管理可能会危及生命。因此，应预期维持氧合和血流动力学稳定性的策略以避免危急情况。在此，我们报告了在支气管气管支架置入管理中使用体外膜肺氧合 (ECMO) 以确保氧合和促进干预。方法。我们回顾性回顾了 2009 年 1 月至 2019 年 12 月期间在 CHU UCL 那慕尔医院（比利时）接受硬质支气管镜检查并在 ECMO 支持下进行支气管气管支架置入术的所有患者。结果. 我们在本研究中纳入了对 11 名患者（3 名患者进行了 2 次支气管镜检查）进行的 14 例支气管镜检查；对男性进行了 12 次，对女性进行了 2 次。中位年龄为 54 岁。中央气道阻塞/狭窄有 11 种良性和 3 种恶性病因。8例由静脉ECMO支持，6例由静脉动脉ECMO支持。中位 ECMO 时间为 267 分钟。在所有情况下，ECMO 支持的撤机都是成功的。在大多数情况下，这些程序得到了有效和安全的执行。仅报告了两个由 ECMO 插管引起的局部并发症，并且调整了抗凝剂以避免手术部位出血和系统中形成凝块。结论. 选择性 ECMO 支持对于使用硬质支气管镜进行支气管气管支架置入的高风险管理是有帮助且安全的，并且与任何其他显着并发症无关。