Allergy Asthma Respir Dis.  2016 Mar;4(2):140-144. 10.4168/aard.2016.4.2.140.

Extracorporeal membrane oxygenation treatment in peanut aspiration with complications

Affiliations
  • 1Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. kwkim@yuhs.ac
  • 2Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
  • 3Division of Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Foreign body aspiration commonly occurs, especially among children younger than 3 years of age. Most endobronchial foreign bodies may be easily removed by bronchoscopy and have a good prognosis. Despite advances in bronchoscopic procedures, difficulties in management of and complications from foreign body aspiration are still noted. We present a foreign body aspiration case with acute respiratory distress syndrome caused aspiration pneumonia, which was successfully treated by bronchoscopy under extracorporeal membrane oxygenation (ECMO). ECMO can be an effective and potentially life-saving method in complicated foreign body aspiration with uncompensated respiratory failure.

Keyword

Child; Foreign body; Aspiration; Extracorporeal membrane oxygenation; Bronchoscopy

MeSH Terms

Bronchoscopy
Child
Extracorporeal Membrane Oxygenation*
Foreign Bodies
Humans
Pneumonia, Aspiration
Prognosis
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency

Figure

  • Fig. 1 (A) The initial chest radiograph showing patchy consolidation in both upper lobes. (B) The initial high resolution computed tomography revealing foreign body in right main bronchus (black arrow) with extensive consolidation in both lung fields and small amount of pneumomediastinum. (C) Chest radiograph after 4 hours from initial following chest radiograph showed bilateral opacification of lungs, compatible with acute respiratory distress syndrome.

  • Fig. 2 Chest radiograph. (A) Immediately following extracorporeal membrane oxygenation (ECMO) cannulation for foreign body aspiration, showing near complete opacification of both lungs indicative of acute respiratory distress syndrome. An ECMO cannula is seen entering at the right internal jugular vein. (B) Following after change veno-venous ECMO to veno-arterial ECMO, showing complete white-out of both lung fields, consistent with acute respiratory distress syndrome. (C) Following after extubation at the 10th hospital day

  • Fig. 3 Neck computed tomography. (A) Showing about 1.7-cm-sized mass-like lesion (white arrow) without enhancement, located in the posterior mediastinum, behind the esophagus, probably hematoma. (B) Showing pseudo aneurysm (black arrow)


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