Dong Phi-Vu, Ter Horst Leontien, Krage Ralf
Department of Anaesthesiology, Catharina Hospital, Eindhoven, The Netherlands.
Department of Anaesthesiology, VU University Medical Centre, Amsterdam, The Netherlands.
BMJ Case Rep. 2018 Jan 26;2018:bcr-2017-222283. doi: 10.1136/bcr-2017-222283.
(Un)anticipated difficult airway remains a challenge in anaesthesia. Percutaneous transtracheal jet ventilation has been shown to be an adequate technique for temporary oxygenation and ventilation and has been described as an acknowledged method in emergency settings of an unanticipated difficult airway. These emergency settings can be considered as low incidence high-risk situations. Both technical and non-technical skills should be trained regularly as education and simulation continues to play an important factor in patient safety. Furthermore, postoperative laryngeal oedema due to altered lymphatic drainage patterns must be considered as a possible mechanism of an upper airway obstruction in combination with a history of neck dissection and radiotherapy.
(未)预料到的困难气道仍然是麻醉领域的一项挑战。经皮气管喷射通气已被证明是一种用于临时氧合和通气的适当技术,并且在预料之外的困难气道的紧急情况下被描述为一种公认的方法。这些紧急情况可被视为低发生率的高风险情况。由于教育和模拟在患者安全方面继续发挥重要作用,技术和非技术技能都应定期进行培训。此外,结合颈部清扫术和放疗史,因淋巴引流模式改变导致的术后喉水肿必须被视为上气道梗阻的一种可能机制。