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Use of extracorporeal membrane oxygenation for bronchoscopic removal of a tracheal foreign body in a child

Published online by Cambridge University Press:  28 September 2022

D V T Harischandra ,
J M R G Jayaweera Open the ORCID record for J M R G Jayaweera [Opens in a new window] ,
A Wickramasinghe  and
R K Firmin
D V T Harischandra
Affiliation:
Cardiothoracic Unit, Teaching Hospital, Karapitiya, Galle, Sri Lanka
J M R G Jayaweera*
Affiliation:
Department of ENT, District General Hospital – Matara, Matara, Sri Lanka
A Wickramasinghe
Affiliation:
ENT Unit, Teaching Hospital Karapitiya, Galle, Sri Lanka
R K Firmin
Affiliation:
Cardiothoracic Unit, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK
*
Author for correspondence: Dr J M R G Jayaweera, Department of ENT, District General Hospital – Matara, Matara 81000, Sri Lanka E-mail: jmranjith@gmail.com
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Abstract

Background

Bronchoscopic removal of a foreign body is a common emergency procedure in paediatric otolaryngology. It is potentially life-threatening, as complete airway obstruction caused by the foreign body can lead to hypoxic cardiac arrest during the manipulation of the object.

Case report

This paper presents a child who had aspirated a foreign body that could not be extracted conventionally via rigid bronchoscopy in the first instance. Subsequently, it was extracted at repeat bronchoscopy under controlled respiratory conditions maintained by an extracorporeal gas exchange circuit – extracorporeal membrane oxygenation, using a polypropylene hollow fibre oxygenator commonly employed in cardiac surgery (rather than a more expensive polymethyl pentene oxygenator commonly used in extracorporeal membrane oxygenation).

Conclusion

Extracorporeal membrane oxygenation use can be considered in exceptional cases of upper airway emergencies, even in resource-poor settings, and can avoid more hazardous thoracotomy and bronchotomy procedures.

Keywords

Airway ObstructionForeign BodiesBronchoscopyExtracorporeal Membrane OxygenationECMO Treatment
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 9 , September 2023 , pp. 1058 - 1061
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr J M R G Jayaweera takes responsibility for the integrity of the content of the paper

References

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