# Differential Lung Ventilation Under the Veno-Arterial Extracorporeal Membrane Oxygenation Assistance in a Patient With a Giant Thoracic Tumor: A Case Report

## TL;DR

This case report describes a patient with a large thoracic tumor causing airway compression, managed using differential lung ventilation and V-A ECMO during surgery.

## Contribution

The paper presents a novel interdisciplinary approach using V-A ECMO to secure airway and manage ventilation in a complex thoracic tumor case.

## Key findings

- V-A ECMO successfully assisted in securing the airway during differential lung ventilation.
- The surgical procedure was completed without complications using the planned strategy.
- Preoperative planning is critical for managing airway stenosis in such patients.

## Abstract

Airway compression resulting from thoracic tumors requires evaluation of the possibility of fatal ventilation failure when securing the airway.

A woman presenting with a thoracic mass on the right side causing airway compression at the level of tracheal bifurcation required tumor removal to alleviate the compression; however, securing the airway proved challenging. Furthermore, differential lung ventilation was necessary for surgical management. We planned to secure the airway and manage breathing with the assistance of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) through an interdisciplinary conference and proceeded according to the plan. The intended tracheal tube could be placed, differential lung ventilation was initiated, and the ECMO was removed. The surgical procedure was carried out.

In patients presenting with airway stenosis, the possibility of difficulty in securing the airway and ventilation should be assessed in advance. Creating a detailed treatment plan before surgery is recommended.