Abstract
A 4-month-old female infant who weighed 3.57 kg with severe subglottic stenosis underwent tracheostomy under extracorporeal cardiopulmonary support. First, we set up extracorporeal cardiopulmonary support to the infant and then successfully intubated an endotracheal tube with a 2.5 mm inner diameter before tracheostomy by otolaryngologists. Extracorporeal cardiopulmonary support is an alternative for maintenance of oxygenation in difficult airway management in infants.
Highlights
We experienced difficult airway management under extracorporeal cardiopulmonary support in an infant with severe subglottic stenosis
Subglottic stenosis can occur in all age groups, pediatric cases can be pathophysiologically divided into two categories, which are congenital and acquired
Our patient was diagnosed with 22q11.2 deletion syndrome (22q11.2DS), which is known as DiGeorge syndrome, DiGeorge anomaly, and velocardiofacial syndrome
Summary
We experienced difficult airway management under extracorporeal cardiopulmonary support in an infant with severe subglottic stenosis. An algorithm of difficult airway management for infants with subglottic stenosis should effectively include extracorporeal cardiopulmonary support. This support includes cardiopulmonary bypass (CPB) and/or extracorporeal membrane oxygenation (ECMO) to maintain blood gas exchange during insecure tracheal intubation and difficult tracheostomy in infants with subglottic airway stenosis
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