AN ALTERNATE APPROACH TO THE MANAGEMENT OF TRACHEAL PERFORATION IN A CHILD

Tracheal perforation can be difficult to manage when standard approach es are not feasible. We present a case report of a 2-year-old child wh o sustained a traumatic laceration of the intrathoracic trachea in the face of tracheitis and bronchitis. Accepted management techniques cou ld not be employed because the child developed mediastinitis and respi ratory distress syndrome. The use of extracorporeal membrane oxygenati on (ECMO) facilitated ventilation and oxygenation when standard modes of ventilation failed. ECMO also provided a compliant low-pressure env ironment that allowed primary tracheal repair by wrapping the tracheal tear with a pedicle of intercostal muscle. A brief overview of the ma nagement of intrathoracic tracheal disruption is presented.