Rapid collaboration between local hospital and major teaching hospital for the treatment of complete airway transection following blunt neck trauma: a case report

Blunt tracheobronchial trauma is a rare and life-threatening condition that demands early diagnosis and prompt intervention to ensure favorable outcomes. The novel aspect of this case lies in the management of a complete tracheal transection at the cricoid level caused by blunt neck trauma, successfully managed with extracorporeal membrane oxygenation (ECMO) as a critical life-saving measure before surgery. A 55-year-old male presented with neck pain, dyspnea, nasal bleeding, and hemoptysis following a cycling accident where a steel wire caused a complete tracheal transection at the cricoid level. CT scans, fiberoptic bronchoscopy, and surgical exploration confirmed blunt tracheobronchial trauma. The patient's mechanical ventilation alarm indicated high pressure and poor oxygenation, necessitating venovenous ECMO for lung replacement therapy. Emergency surgery, including tracheoplasty, tracheostomy, neck debridement, and muscle flap reconstruction, was performed at a tertiary hospital with ECMO support. This case highlights the critical role of ECMO in the management of severe tracheobronchial trauma, especially when conventional treatments fail. The use of ECMO provided vital support, allowing sufficient time for surgical repair and leading to a successful recovery for the patient. This approach may significantly impact future treatment strategies for similar cases of life-threatening blunt tracheobronchial injuries.