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The Role of ECMO in the “At-Risk” Tracheal Extubation

A Case Report

Phipps, Sarah J., MBChB, FANZCA*; Meisner, Jason G., MD, PhD*; Watton, David E., MD*; Malpas, Gemma A., MBChB, FANZCA*; Hung, Orlando R., MD, FRCPC

doi: 10.1213/XAA.0000000000000838
Case Reports

Tracheal extubation requires careful planning and preparation. We present the extubation of a patient with severe ankylosing spondylitis after cervical spine surgery. We discuss the use of extracorporeal membrane oxygenation (ECMO) in this “at-risk” extubation, where our ability to oxygenate was uncertain and reintubation was predicted to be difficult. To our knowledge, ECMO has not previously been used in this context. We suggest preparing ECMO for rescue oxygenation when all other fundamental oxygenation techniques are predicted to be difficult or impossible. ECMO could be included in airway management and extubation guidelines.

From the Departments of *Anesthesiology

Anesthesiology, Surgery, and Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.

Accepted for publication May 31, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Sarah J. Phipps, MBChB, FANZCA, Department of Anesthesia, Queen Elizabeth II Health Sciences Center, 1276 S Park St, Halifax, NS B3H 2Y9, Canada. Address e-mail to

© 2019 International Anesthesia Research Society
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