Summary of 4 cases of minimally invasive tracheotomy for severe pneumonia under extracorporeal membrane oxygenation
10.3969/j.issn.1008-9691.2023.06.010
- VernacularTitle:体外膜肺氧合下重症肺炎患者微创气管切开4例经验总结
- Author:
Bin LI
1
;
Fenglei XU
;
Ming XIA
;
Xiaoming LI
;
Zhenxiao WANG
;
Huiming YANG
;
Xiaozhi HOU
Author Information
1. 山东第一医科大学附属省立医院耳鼻咽喉头颈外科,山东济南 250021
- Keywords:
Severe pneumonia;
Intensive care unit;
Veno-venous extracorporeal membrane pulmonary oxygenation;
Minimally invasive tracheotomy;
Percutaneous dilatational tracheotomy
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2023;30(6):688-692
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experience of minimally invasive tracheotomy under veno-venous extracorporeal membrane oxygenation(VV-ECMO)in 4 cases of severe pneumonia,and to provide examples for airway management of severe pneumonia patients.Methods A retrospective study method was conducted.Four cases of severe pneumonia patients who underwent extracorporeal membrane oxygenation(ECMO)at the intensive care unit(ICU)of Shandong Provincial Hospital Affiliated to Shandong First Medical University from November 2022 to March 2023 were selected as the study subjects,clinical data on the general conditions,imaging examinations before and after admission to ICU,changes in biochemical indexes before and after ECMO technique,and the performance of bedside minimally invasive tracheotomy were collected.Bedside tracheotomy was performed to assist ventilation for patients according to the change of condition.The changes and prognosis of the patients were observed.Results Four patients with severe pneumonia were treated with bedside tracheotomy-assisted ventilation in the state of continuous VV-ECMO,the oxygen saturation was maintained between 0.98-1.00,the airway was cleared and sputum evacuation was smooth,the vital signs were stable after the operation,and the machine was gradually withdrawn.Conclusion During the treatment of severe pneumonia,the safe and rapid completion of bedside minimally invasive tracheotomy in patients with severe pneumonia under continuous VV-ECMO is a new challenge shared by doctors and nurses of otorhinolaryngology,head and neck surgery,and critical care emergency care unit.The four successful cases of bedside tracheotomy after VV-ECMO treatment we report suggest that bedside minimally invasive tracheotomy can safely and rapidly assist airway management,and may provide more useful experiences for the treatment of severe pneumonia and possible new acute respiratory infectious diseases in the future.
