Albert H Park1, David E Tunkel2, Erica Park3, Douglas Barnhart4, Edward Liu5, Justin Lee4, Richard Black4. 1. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, United States. Electronic address: pcapark@ihc.com. 2. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, United States. 3. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, United States. 4. Division of Pediatric Surgery, Department of Surgery, University of Utah, United States. 5. Pediatric Anesthesia, Primary Children's Hospital, United States.
Abstract
OBJECTIVES: Successful removal of an airway foreign body can be very challenging. We present three patients with airway foreign body aspiration successfully treated using extracorporeal membrane oxygenation (ECMO). Their clinical presentation and findings will be reviewed to determine when ECMO should be considered for treatment. STUDY DESIGN: Retrospective multi-institutional review of a case series of patients with airway foreign body who underwent successful treatment using ECMO. METHOD: After institutional review board approval, the use of ECMO during airway foreign body procedures in children was reviewed from the pediatric research in otolaryngology (PRO) network. This network comprises of over 20 Children's hospitals to improve the health of and healthcare delivery to children and their families with otolaryngology conditions. Specific parameters were recorded for each patient. RESULTS: Three children presented with airway foreign body and required ECMO for successful removal. Mean age was 18 months. Presenting symptoms included severe and worsening respiratory distress. Indications for ECMO included an inability to perform rigid bronchoscopy due to the child's unstable respiratory status and an airway foreign body lodged in the trachea that could not be removed without potential loss of airway support. All three children underwent successful removal of their airway foreign bodies. There were no complications from ECMO or bronchoscopy. CONCLUSION: ECMO may be a useful adjunct in cases of life threatening airway foreign body aspiration.
OBJECTIVES: Successful removal of an airway foreign body can be very challenging. We present three patients with airway foreign body aspiration successfully treated using extracorporeal membrane oxygenation (ECMO). Their clinical presentation and findings will be reviewed to determine when ECMO should be considered for treatment. STUDY DESIGN: Retrospective multi-institutional review of a case series of patients with airway foreign body who underwent successful treatment using ECMO. METHOD: After institutional review board approval, the use of ECMO during airway foreign body procedures in children was reviewed from the pediatric research in otolaryngology (PRO) network. This network comprises of over 20 Children's hospitals to improve the health of and healthcare delivery to children and their families with otolaryngology conditions. Specific parameters were recorded for each patient. RESULTS: Three children presented with airway foreign body and required ECMO for successful removal. Mean age was 18 months. Presenting symptoms included severe and worsening respiratory distress. Indications for ECMO included an inability to perform rigid bronchoscopy due to the child's unstable respiratory status and an airway foreign body lodged in the trachea that could not be removed without potential loss of airway support. All three children underwent successful removal of their airway foreign bodies. There were no complications from ECMO or bronchoscopy. CONCLUSION: ECMO may be a useful adjunct in cases of life threatening airway foreign body aspiration.