Iatrogenic tracheal rupture is a rare complication of endotracheal intubation and has a high risk of morbidity and mortality. Risk factors include female gender, short stature (height less than 160-cm), difficult airway anatomy, underlying connective tissue disorder, chronic obstructive pulmonary disease, use of a rigid stylet, inadequate intubation tube size, cuff over-inflation, emergent intubation and intubation performed by non-anesthesiologists. 1 Early recognition is important and diagnosis requires bronchoscopic confirmation.2,3 We describe a case where emergent venovenous extra-corporeal membrane oxygenation (VV-ECMO) was utilized in the management of tracheal rupture.


  • Tracheal rupture is an uncommon but severe complication of endotracheal intubation.
  • VV ECMO may be used as a bridge to definitive management of tracheal rupture in patients with progressive respiratory failure who failed conservative strategies.
  • Further studies should identify patients who may benefit from early surgical management and/or transfer to a facility that has ECMO capabilities.