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

Shaun M. Kunisaki, Dario O. Fauza, Nancy Craig, Russell W. Jennings

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)800-804
Number of pages5
JournalJournal of pediatric surgery
Volume43
Issue number5
DOIs
StatePublished - May 1 2008
Externally publishedYes

Keywords

  • Congenital tracheal stenosis
  • ECMO
  • Extracorporeal membrane oxygenation
  • Tracheal reconstruction

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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