Bronchoscopy-Guided Intervention Therapy With Extracorporeal Membrane Oxygenation Support for Relapsing Polychondritis With Severe Tracheobronchomalacia: A Case Report and Literature Review

Frontiers in Medicine

Wei Yu¹  Bing Fu²  Wenhui Huang²  Chuantao Zhang³  Pengcheng Zhou³  Keling Chen³  Wenjun Tang³  Qianming Xia⁴ 

[1] Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China;Department of Cardiothoracic Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China;Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China;Department of Respiratory Medicine, The Aviation Industry Corporation of China (AVIC) 363 Hospital, Chengdu, China;

关键词: extracorporeal membrane oxygenation;    relapsing polychondritis;    tracheobronchomalacia;    severe airway stenosis;    bronchoscopy;    interventional therapy;   

DOI  :  10.3389/fmed.2021.695505

来源: DOAJ

【 摘 要 】

Relapsing polychondritis is an immune disorder of unknown etiology involving multiple systems that is characterized by persistent inflammation and destruction of cartilage, including the ears, nose, costal, joint, and airways. Airway involvement caused by relapsing polychondritis is common, and tracheobronchomalacia is the most serious complication, which is life-threatening. Currently, the exact mechanism of relapsing polychondritis with tracheobronchomalacia is unknown. Although glucocorticoids and immunosuppressive agents are administered, failures often occur. Currently, bronchoscopy-guided intervention therapy used in tracheobronchomalacia caused by chronic obstructive pulmonary disease or other etiology has gradually increased, but bronchoscopy-guided intervention therapy with extracorporeal membrane oxygenation assist used in tracheobronchomalacia caused by relapsing polychondritis has not been reported. Here, we report a case of relapsing polychondritis with severe tracheobronchomalacia. Although drug therapy was provided and airway stent implantation was performed, the tracheal stenosis was further aggravated. Because conventional anesthesia and mechanical ventilation cannot meet the needs of bronchoscopy-guided intervention therapy or guarantee sufficient safety. The intervention treatment was performed with the support of extracorporeal membrane oxygenation, which was successfully completed without obvious complications. The symptoms were significantly improved, and the patient was discharged uneventfully.

【 授权许可】

Unknown