[Elective use of extracorporeal lung assist: prevention of an airway disaster].

The use of extracorporeal membrane oxygenation (ECMO) was established in Germany 25 years ago in specialized centers as an approach for patients suffering from severe life-threatening lung failure. Apart from such indications the inclusion of ECMO as a planned intervention for safety purposes in the postoperative weaning from mechanical ventilation in a 22-year-old woman is described. Following a complex tracheal reconstruction due to oesophageal-tracheal fistula formation, conventional weaning procedures would have been accompanied by a very high risk as extubation failure might have caused an airway disaster. After elective use of veno-venous ECMO the young patient was extubated without risk and lung function was stabilized safely. Extracorporeal lung assist can be indicated apart from rescue management in elective situations for prevention of an airway catastrophe after careful calculation of the harm/benefit ratio.