Engoren M, de St Victor P
Department of Anesthesiology and Internal Medicine, St. Vincent Mercy Medical Center, Toledo, OH 43608, USA.
Chest. 2000 Dec;118(6):1833-5. doi: 10.1378/chest.118.6.1833.
Cricothyroidotomy can be a life-saving procedure for the "can't intubate, can't ventilate" patient who has upper-airway obstruction. The procedure is usually fast and easy to do; however, complications have been reported. We report two cases in which cricothyroidotomy with an endotracheal tube led to unrecognized endobronchial intubation, ipsilateral tension pneumothorax, contralateral presumed pneumothorax, and unnecessary emergency surgery. Additionally, these led to the triad of hypotension, hypoxemia, and, probably, elevated intracranial pressure, which can worsen cerebral injury. We discuss methods to avoid these complications.
对于存在上气道梗阻的“无法插管、无法通气”患者，环甲膜切开术可能是一种挽救生命的手术。该手术通常操作迅速且简便；然而，已有并发症的报道。我们报告两例病例，其中使用气管内导管进行环甲膜切开术导致未被识别的支气管内插管、同侧张力性气胸、对侧疑似气胸以及不必要的急诊手术。此外，这些情况还导致了低血压、低氧血症以及可能的颅内压升高这一组三联征，而这会加重脑损伤。我们讨论了避免这些并发症的方法。
