“Cannot Intubate_Cannot Ventilate” Emergency: Airway Management of Difficult Airway in a Patient; A Case Report

  • Valiollah Hasani Department of Anesthesiology and Critical Care, IranUniversity of Medical Sciences, Tehran, Iran
  • Reza Farahmandrad MD. Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, Iran
  • Majid Behrooznia Department of Anesthesiology and Critical Care, IranUniversity of Medical Sciences, Tehran, Iran
  • Louis Jafari Department of Anesthesiology and Critical Care, IranUniversity of Medical Sciences, Tehran, Iran
  • Farideh Mohammadi alasti Department of Anesthesiology and Critical Care, IranUniversity of Medical Sciences, Tehran, Iran
  • Fazlollah Mojahed Department of Anesthesiology and Critical Care, IranUniversity of Medical Sciences, Tehran, Iran
Keywords: airway emergency, jet ventilation, CICV, airway management

Abstract

The present study reports a 42 years old male patient with modular thyroid cancer. The patient became candidate for direct laryngoscopy (DL) in order to observe the condition of the lesion in the trachea and probable biopsy, and subsequent surgery. After a few moments, it was observed that the patient cannot be ventilated. Immediately, the patient was tried to be intubated but was not successful and thus, quick track was put for the patient rapidly and he was connected to the jet ventilation machine. But after a short time, suddenly the patient got bradycardia and respiratory interruption and drop in saturation that the patient underwent CPR operation which continued for 30 seconds which resulted finally in the patient’s heart rate reaching 100 and spontaneous breathing began. After auscultation of lungs, bilateral pneumothorax was diagnosed that according to previous studies, is probably a complication resulting from trans tracheal jet ventilation (TTJV). This complication was resolved through needle aspiration. After 4 hours, the surgery was over and the patient, with stable vital signs and spontaneous breathing, was sent to the intensive care unit.In some previous studies, the researchers have suggested using open surgical technique in order to reduce the complications resulting from cannot intubate, cannot ventilate (CICV), and the present study also supports this suggestion and recommends it to other anesthesiologists when facing CICV situation, in order to reduce the complications resulting from jet ventilation and its subsequent damages.

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Published
2018-06-30
How to Cite
1.
Hasani V, Farahmandrad R, Behrooznia M, Jafari L, Mohammadi alasti F, Mojahed F. “Cannot Intubate_Cannot Ventilate” Emergency: Airway Management of Difficult Airway in a Patient; A Case Report. AACC. 4(3):513-6.
Section
Case Report(s)