Extracorporeal life support and cardiopulmonary bypass for central airway surgery: A systematic review
| Autor: | Vakhtang Tchantchaleishvili, H. Todd Massey, Nathaniel R. Evans, Scott W. Cowan, Colin C Yost, Abhiraj Saxena, Rohinton J. Morris, Tyler R. Grenda, Thomas J. O’Malley, Kyle W. Prochno |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Respiratory System Biomedical Engineering Medicine (miscellaneous) Bioengineering Extracorporeal law.invention Biomaterials Extracorporeal Membrane Oxygenation law medicine Cardiopulmonary bypass Extracorporeal membrane oxygenation Humans Intubation Airway Management Cardiopulmonary Bypass business.industry General Medicine Perioperative medicine.disease Surgery Stenosis Life support Breathing business |
| Zdroj: | Artificial Organs. 46:362-374 |
| ISSN: | 1525-1594 0160-564X |
| Popis: | BACKGROUND Major airway surgery can pose a complex problem to perioperative central airway management. Adjuncts to advanced ventilation strategies have included cardiopulmonary bypass, veno-arterial, or veno-venous extracorporeal life support. We performed a systematic review to assess the existing evidence utilizing these strategies. METHODS An electronic search was conducted to identify studies written in English reporting the use of extracorporeal life support (ECLS) during central airway surgery. Thirty-six articles consisting of 78 patients were selected and patient-level data were analyzed. RESULTS Median patient age was 47 [IQR: 34-53] and 59.0% (46/78) were male. Indications for surgery included central airway or mediastinal cancer in 57.7% (45/78), lesion or injury in 15.4% (12/78), and stenosis in 12.8% (10/78). Support was initiated pre-operatively in 9.9% (7/71) and at the time of induction in 55.3% (42/76). It was most commonly used at the time of tracheal resection/repair [93.2% (68/73)], intubation of the tracheal stump [94.4% (68/72)], and re-anastomosis [94.2% (65/69)]; 13.7% (10/73) patients were supported post-operatively. The most commonly performed surgery was tracheal repair or resection in 70.3% (52/74). Median hospital stay was 12 [8, 25] days and in-hospital mortality was 7.9% (6/76). There was no significant difference in survival between the three groups (p = .54). CONCLUSIONS Extracorporeal membrane oxygenation offers versatility in timing, surgical approach, and ECLS runtime that makes it a viable addition to the surgical armamentarium for treating complex central airway pathologies. |
| Databáze: | OpenAIRE |
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