Difficult intubation in critical patient: how can we manage it? a case report
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Abstract
Difficult airway management represents a challenge. Guidelines recommend choosing the airway technique based on physicians’ skills, equipment, available devices and context. Supraglottic airway devices are recommended in cases of unanticipated difficult intubation after endotracheal intubation failure. They are used to ensure satisfactory oxygenation and occasionally to guide the endotracheal tube. Fiberscope is useful to ensure vision of larynx and trachea in these scenarios. This is a unique case of emergency and difficult airway management using this combined approach. In our experience, oxygenation with laryngeal mask and intubation through the mask under endoscopic vision is valid combination technique.
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2. Aziz MF, Brambrink AM, Healy DW, Willett AW, Shanks A, Tremper T, et al. Success of intubation rescue techniques after failed direct laryngoscopy in adults: a retrospective comparative analysis from the multicenter perioperative outcomes group. Anesthesiology. 2016;125(4):656-66.
3. Saraniti C, Barbara V. Thunderbeat®: a new step forward in transoral surgery-systematic review of literature and our experience. Eur Arch Otorhinolaryngol. 2023;280(7):3415-25.
4. Michailidou M, O'Keeffe T, Mosier JM, Friese RS, Joseph B, Rhee P, et al. A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World J Surg. 2015;39(3):782-8.
5. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult airway society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115(6):827-48.
6. Caponas G. Intubating laryngeal mask airway. Anaesth Intensive Care. 2002;30(5):551-69.
7. Taneja S, Agarwalt M, Dali JS, Agrawal G. Ease of proseal laryngeal mask airway insertion and its fibreoptic view after placement using gum elastic bougie: a comparison with conventional techniques. Anaesth Intensive Care. 2009;37(3):435-40.
8. Edelman DA, Perkins EJ, Brewster DJ. Difficult airway management algorithms: a directed review. Anaesthesia. 2019;74(9):1175-85.
9. McAleavey F, Michalek P. Aura-i laryngeal mask as a conduit for elective fibreoptic intubation. Anaesthesia. 2010;65(11):1151.
10. Wong DT, Yang JJ, Mak HY, Jagannathan N. Use of intubation introducers through a supraglottic airway to facilitate tracheal intubation: a brief review. Can J Anaesth. 2012;59(7):704-15.
2. Aziz MF, Brambrink AM, Healy DW, Willett AW, Shanks A, Tremper T, et al. Success of intubation rescue techniques after failed direct laryngoscopy in adults: a retrospective comparative analysis from the multicenter perioperative outcomes group. Anesthesiology. 2016;125(4):656-66.
3. Saraniti C, Barbara V. Thunderbeat®: a new step forward in transoral surgery-systematic review of literature and our experience. Eur Arch Otorhinolaryngol. 2023;280(7):3415-25.
4. Michailidou M, O'Keeffe T, Mosier JM, Friese RS, Joseph B, Rhee P, et al. A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World J Surg. 2015;39(3):782-8.
5. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult airway society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115(6):827-48.
6. Caponas G. Intubating laryngeal mask airway. Anaesth Intensive Care. 2002;30(5):551-69.
7. Taneja S, Agarwalt M, Dali JS, Agrawal G. Ease of proseal laryngeal mask airway insertion and its fibreoptic view after placement using gum elastic bougie: a comparison with conventional techniques. Anaesth Intensive Care. 2009;37(3):435-40.
8. Edelman DA, Perkins EJ, Brewster DJ. Difficult airway management algorithms: a directed review. Anaesthesia. 2019;74(9):1175-85.
9. McAleavey F, Michalek P. Aura-i laryngeal mask as a conduit for elective fibreoptic intubation. Anaesthesia. 2010;65(11):1151.
10. Wong DT, Yang JJ, Mak HY, Jagannathan N. Use of intubation introducers through a supraglottic airway to facilitate tracheal intubation: a brief review. Can J Anaesth. 2012;59(7):704-15.
| Files | ||
| Issue | Vol 8 No 3 (2024): Summer (July) | |
| Section | Case (report / study) | |
| DOI | 10.18502/fem.v8i3.16334 | |
| Keywords | ||
| Airway Management Bronchoscopes Emergency Treatment Laryngeal Masks | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Ottoveggio G, Verro B, Nicosia D, Saraniti C. Difficult intubation in critical patient: how can we manage it? a case report. Front Emerg Med. 2024;8(3):e27.
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