ReviewJournal of thoracic disease2026
Narrative review of extracorporeal membrane oxygenation utilization in surgical management of tracheal intubation injuries.
Review in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
Background and Objective: Tracheobronchial injuries are a rare complication of intubation but carry a high mortality. When surgical airway repair is necessary, veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be required to maintain gas exchange. To better understand contemporary utilization of VV-ECMO in surgical airway repairs, we undertook a comprehensive literature review. Methods: Using the PubMed database, we identified 1,013 potentially relevant publications and 13 of these, describing 14 patient cases, met criteria. Key Content and Findings: Demographics and histories were consistent with prior studies of intubation injuries and included a female predominance (93%) and a high rate of emergent (64%) as well as double-lumen endotracheal tube (ETT) (14%) intubations. Injury length was 3.9±1.7 [mean ± standard deviation (SD)] centimeters (cm). Notably, injuries were located in the membranous airway in all cases (N=12) where injury location was reported. VV-ECMO was used in all cases, but cannulation configuration varied. Anticoagulation was used in 36% of cases upon VV-ECMO initiation and an additional 14% added anticoagulation post-operatively. Postoperative complications included one patient with both a perforated duodenal ulcer and a deep venous thrombosis (DVT), one surgical re-exploration for bleeding, one case of pneumonia with subsequent sepsis, and one patient with bilateral vision loss attributed to hypoxemia with resolution following a 2-day course of steroids. VV-ECMO duration ranged from 0 to 14 days with a mean of 4.3±4.7 days. Average length of stay was 24.9±16.6 days. Importantly, we identified four cases in which VV-ECMO was used post-operatively to reduce (3 cases) or eliminate (1 case) post-operative positive pressure ventilation (PPV) with a goal of decreasing repair failure. Conclusions: Taken together, these findings extend our understanding of iatrogenic intubation injuries of the airway and their operative management with VV-ECMO support.
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