Cai Sunny R, Sandhu Mani Ratnesh S, Gruenbaum Shaun E, Rosenblatt William H, Gruenbaum Benjamin F
Anesthesiology, Yale School of Medicine, New Haven, USA.
Laboratory Medicine, Yale School of Medicine, New Haven, USA.
Cureus. 2020 Sep 24;12(9):e10638. doi: 10.7759/cureus.10638.
A "difficult airway" should be suspected in patients with any anatomical or physiologic abnormality that might result in the loss of the airway or significant cardiopulmonary compromise upon induction of general anesthesia. Historically, an awake intubation has often been the preferred approach for airway management in these patients. Here we describe a case in which an awake intubation was safely performed in a patient with both anatomical (i.e., laryngeal mass) and physiologic (i.e., pulmonary hypertension) abnormalities. Oxygenation, airway patency, and spontaneous breathing were well maintained with successful intubation on the first attempt. We recommend that the patient's physiologic state should always be considered in airway management planning.
对于存在任何可能导致气道丧失或在全身麻醉诱导时出现严重心肺功能损害的解剖或生理异常的患者，应怀疑为“困难气道”。从历史上看，清醒插管常常是这些患者气道管理的首选方法。在此，我们描述一例在同时存在解剖学异常（即喉部肿物）和生理学异常（即肺动脉高压）的患者中成功实施清醒插管的病例。首次尝试插管即成功，氧合、气道通畅及自主呼吸均得到良好维持。我们建议在气道管理规划中始终考虑患者的生理状态。
