Two Birds, One Stone: Awake Extracorporeal Life Support

Case

A 55 year old female, no previous medical history, underwent out-of-hospital cardiac arrest. Advanced cardiac life support (ACLS) was initiated, with return of spontaneous circulation after 30’ of conventional resuscitation efforts. At first hospital arrival coronary angiography and successful percutaneous transluminal angioplasty were performed to treat right coronary artery stenosis.

Incidentally, lung computed tomography (CT) revealed signs of aspiration pneumonia (Figure 1). Moreover, as a result of improper out-of-hospital endotracheal tube (ETT) positioning (ID 7.5/OD 10.7 mm) during ACLS, the patient suffered iatrogenic airway injury, as confirmed by bronchoscopy (12 x 19 mm respectively sagittal and longitudinal axis,