Extracorporeal membrane oxygenation support in patients with difficult airway management: Case series of 13 patients

Table 1 Patient demographics and initial presentation

Patient	Age	Gender	Morbidity	Diagnosis	CT findings	Type of ECMO	ECMO duration	Surgical intervention	Complications on ECMO	90 days outcome
1	29	Male	Non	T- lymphoblastic leukemia	Near-total tracheal obstruction	ECMO team standby	0 days	Non, intubated and underwent chemotherapy	N/A	Alive
2	54	Male	HTN, CAD	Post COVID intubation subglottic stenosis	Subglottic tracheal stenosis	ECMO standby guidewires inserted	0 days	Tracheal resection with end-to-end anastomosis	N/A	Alive
3	44	Male	Non	Recurrent follicular thyroid cancer	External tracheal compression	ECMO team standby	0 days	Tumor excision + neck dissection and sternectomy with reconstruction	N/A	Alive
4	64	Female	HTN, DM	Post COVID intubation subglottic stenosis	Fibrous band at the level of second tracheal ring	ECMO team Standby	0 days	Excision and balloon dilatation	N/A	Alive
5	37	Female	HTN, DM, CKD	Tracheal stenosis post prolonged intubation	50% subglottic stenosis	ECMO team standby	0 days	Tracheal dilation	N/A	Alive
6	68	Female	HTN, CAD	Tracheal tumor	Mediastinal tumor infiltrating into the distal trachea and bronchi, bilaterally	VV ECMO	5 days	Tumor debulking and bilateral bronchial/tracheal stenting	N/A	Alive
7	70	Female	HTN	Post COVID intubation tracheal stenosis	Tracheal stenosis	ECMO team standby	5 days	Tracheal dilation + stenting	N/A	Alive
8	50	Female	Non	Tracheal stenosis post COVID-19	Long segment of subglottic tracheal stenosis	VV ECMO	45 minutes	Tracheal dilation + stenting	N/A	Alive
9	50	Male	Non	Tracheal stenosis post COVID-19	Tracheal stenosis	VV ECMO	2 days	Tracheal resection and anastomosis	N/A	Alive
10	28	Female	Non	Thyroid cancer with pulmonary metastasis	External tracheal compression	VV ECMO	11 days	Endobronchial lesion removal and stenting	N/A	Alive
11	44	Male	Non	Acute lymphoblastic leukemia	Mediastinal mass causing near-total tracheal obstruction	ECMO team Standby	0 days	Non, intubated and underwent chemotherapy	N/A	Alive
12	28	Female	CKD, lung cancer	Metastatic lung adenocarcinoma	Large intra tracheal tumor expanding over 80% of the lumen	VV ECMO	16 days	Failed balloon dilatation and stenting, underwent. Radiotherapy	N/A	Died 21 days after ECMO decannulation
13	29	Male	Non	Post traumatic airway injury stenosis	Tracheal stenosis with surrounding soft tissue component	VV ECMO	10 days	Tracheal dilatation and stenting	Tension pneumothorax cardiac arrest	Alive
	4 months later the patient developed SOB and strider			Tracheal stent in situ with distal stenosis	Narrowing below the lower end of the stents about 8 mm in diameter	No ECMO was available	0	Flexible + rigid bronchoscopy, extraction of tracheal stent, +- replacement with shorter stent +- thoracotomy and tracheal repair	N/A	Failed ventilation and died on the theatre table

VV ECMO: Veno-venous Extracorporeal membrane oxygenation; COVID-19: Coronavirus disease 2019; CT: Computed tomography; SOB: Shortness of breath; HTN: Hypertension; CAD: Coronary artery disease; CKD: Chronic kidney disease; DM: Diabetes mellitus.