Benefits of extracorporeal membrane oxygenation for major blunt tracheobronchial trauma in the paediatric age group

Abstract

Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury among children. The severity of this condition ranges from death before hospital admission to clinical stability resulting in delayed management. Diagnosis is difficult because there is sometimes no evidence of external trauma, in spite of severe chest crush injury and consecutive rupture of airways. Here, we report the case of a 32-month-old girl whose torso was crushed by a van, resulting in bilateral bronchi disconnection. She was admitted to our hospital with cardiac and respiratory arrest. After prompt resuscitation, flexible bronchoscopy permitted the accurate visualization of the rupture and its extent. The life-saving procedure consisted of surgical repair using extracorporeal membrane oxygenation (ECMO) as ventilatory support. This provided rapid relief from the injury, which was previously expected to result in death. These data suggest that ECMO could be beneficial as supportive therapy for selected paediatric patients with major tracheobronchial traumas.