"Can't Intubate Can't Oxygenate" Situation in an Elective Patient in Suspected Sarcoidosis: A Case Report.

3rd generation laryngeal mask CICO curare difficult airway ventilation microlaryngeal tube

Journal

European journal of case reports in internal medicine
ISSN: 2284-2594
Titre abrégé: Eur J Case Rep Intern Med
Pays: Italy
ID NLM: 101648453

Informations de publication

Date de publication:
2023
Historique:
received: 31 08 2023
accepted: 04 09 2023
medline: 3 11 2023
pubmed: 3 11 2023
entrez: 3 11 2023
Statut: epublish

Résumé

Anaesthetists and pulmonologists are well trained to follow the "can't intubate, can't oxygenate" (CICO) protocol but the procedure is rarely practised. This case report concerns an elective patient scheduled for endobronchial ultrasound bronchoscopy (EBUS) because of suspected sarcoidosis. Based on known medical history, anaesthesia for EBUS procedure was initiated with a laryngeal mask. The airway turned out to be difficult and the patient was not ventilable despite several efforts including curarization and orotracheal intubation. Rapid desaturation imposed to apply the CICO protocol with emergency cricothyroidotomy as extreme measure but also failed. 6-handed face mask ventilation was continued. Eventually, introduction of a microlaryngeal tube of the 3 The CICO protocol was effective to manage an unanticipated difficult airway. The patient was resuscitated with the use of a microlaryngeal endotracheal tube of the 3

Identifiants

pubmed: 37920228
doi: 10.12890/2023_004088
pii: 4088
pmc: PMC10619535
doi:

Types de publication

Journal Article

Langues

eng

Pagination

004088

Informations de copyright

© EFIM 2023.

Déclaration de conflit d'intérêts

Conflicts of Interests: The Authors declare that there are no competing interests.

Références

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Auteurs

Veronica Gerli (V)

Anaestesiology, Ospedale Regionale di Lugano - Civico e Italiano, Ente Ospedaliero cantonale, Lugano, Switzerland.

Eva Koetsier (E)

Pain Management Center, Neurocenter of Southern Switzerland, Ente Ospedaliero cantonale, Lugano, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.

Nicola Ledingham (N)

Anaestesiology, Ospedale Regionale di Lugano - Civico e Italiano, Ente Ospedaliero cantonale, Lugano, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.

Paolo Maino (P)

Anaestesiology, Ospedale Regionale di Lugano - Civico e Italiano, Ente Ospedaliero cantonale, Lugano, Switzerland.
Pain Management Center, Neurocenter of Southern Switzerland, Ente Ospedaliero cantonale, Lugano, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.

Classifications MeSH