Anesthetic Management of the Narrowed Airway
Airway narrowing can be idiopathic or can occur as a result of airway tumors, hematomas, infections, and other pathologic conditions. Endoscopic management variously involves balloon dilatation, stent placement, laser vaporization of pathologic tissue, microdebridement, and other interventions, using either a rigid or a flexible bronchoscope. Jet ventilation is frequently used in such settings, especially when the presence of an endotracheal tube would interfere with the procedure. In desperate cases, extracorporeal membrane oxygenation may be used in managing the critical airway.
Publication date: Available online 10 October 2019Source: The Annals of Thoracic SurgeryAuthor(s): Yasuto Sakaguchi, Kazuya Matsumoto, Kensuke Nishioka, Norishige Iizuka, Yutaka Hirayama, Aya Kitaoka, Kazuya Tanimura, Ken-ichi Takahashi, Motokazu KatoAbstractTracheobronchopathia osteochondroplastica is a rare benign condition where multiple cartilaginous or bony submucosal nodules project into the trachea or bronchi. A 71-year-old man complained of cough for 3 months. Computed tomography scanning revealed a calcified tracheal tumor near the tracheal bifurcation. Pulmonary function testing indicated airflow limitation, and ...
Abstract Tracheobronchopathia osteochondroplastica is a rare benign condition where multiple cartilaginous or bony submucosal nodules project into the trachea or bronchi. A 71-year-old man complained of cough for 3 months. Computed tomography scanning revealed a calcified tracheal tumor near the tracheal bifurcation. Pulmonary function testing indicated airflow limitation, and bronchoscopic examination confirmed a solitary rigid tumor. Bronchoscopic resection was performed under general anesthesia, and the tumor was detached by cauterizing its stem with high-frequency coagulation. The tumor was pathologically indi...
Arun Raja Thangavel, Sakthirajan Panneerselvam, Priya Rudingwa, Ranjith Kumar SivakumarIndian Journal of Anaesthesia 2019 63(10):862-863
Condition: Sedation or Anesthesia Interventions: Drug: HSK3486; Drug: Propofol Sponsor: Sichuan Haisco Pharmaceutical Group Co., Ltd. Not yet recruiting
Conclusion: The findings from this case suggest that the use of ECMO before the induction of general anesthesia is a safe method for maintaining oxygenation in patients with severe tracheal obstruction.
Conclusion: CT-measured bronchial width predicts the appropriate DLT size better than conventional method. In the absence of CT scan facility, patient height, age, and chest X-ray TW may be used to predict DLT size with reasonable accuracy. PMID: 31621669 [PubMed - in process]
Conclusions: DLT has a low malpositioning rate and is the preferred device to achieve OLV. BRO use recorded was unexpectedly low. The possibility of encountering a difficult airway is frequent, with an overall prevalence of 16%. Risk factors of desaturation are malposition and increased size of DLT. Left procedures and BRO use could lead to fewer episodes of desaturation. PMID: 31559028 [PubMed]
This article offers the interventional pulmonologist insight into how the anesthesiologist thinks and approaches anesthetic care delivery.
Conditions: Transbronchial Cryobiopsy; Anesthesia; Tracheal Intubation; Rigid Bronchoscopy; Safety Intervention: Procedure: anesthesia Sponsor: Guangzhou Institute of Respiratory Disease Not yet recruiting